CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Sunrise Hospital and Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $381
Cash Discount Price: $1,146
vs. Medicare Baseline: 0.31x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Sunrise Hospital and Medical Center is $381. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,146. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.31x the Medicare baseline. Located in 3186 S Maryland Pkwy, Las Vegas, NV.

Cash / Self-Pay

$1,146

Average discount available for prompt cash payment at this facility.

Insurance Median

$381

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$1,222.56

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $1,222.56 (100%)

Cash / Self-Pay: $1,146 (94%)

Insurance Median: $381 (31%)

Cash: $1,146 (94% of Medicare)

Ins. Median: $381 (31% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $1,222.56 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Humana	$141 - $2,704	12%
Amerigroup	$160 - $297	13%
Health Plan Nevada	$160 - $312	13%
Molina	$168 - $328	14%
Silver Summit	$168 - $515	14%
Healthcare Partners Of Nv	$187 - $559	15%
Aetna	$190 - $2,138	16%
Alignment Health Plan	$190 - $412	16%
Blue Cross Blue Shield	$190 - $3,839	16%
United	$195 - $2,295	16%
Caremore	$200 - $433	16%
Hometown Health Providers	$219 - $2,339	18%
Community Care Health	$244 - $333	20%
Molina Healthcare	$244 - $346	20%
Sierra Hpn	$244 - $333	20%
Sierra	$248 - $1,884	20%
Cigna	$250 - $2,482	20%
Culinary Health Fund	$251 - $618	21%
Multiplan	$253 - $3,500	21%
Caresource	$346	28%
Select Health	$382 - $5,307	31%
Legacy Provider Network	$1,143	93%
Corvel	$1,206 - $1,520	99%
Comp-Med Workers Comp	$1,232	101%
Olympus Medsave Usa	$1,270 - $1,600	104%
Ambetter / Centene	$2,550 - $2,626	209%
Health Services Coalition	$4,260	348%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,146.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 45380.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sunrise Hospital and Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 45380.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.