CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Mountainview Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $2,016
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Mountainview Hospital is $2,016. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.65x the Medicare baseline. Located in 3100 N Tenaya Way, Las Vegas, NV.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,016

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%)

Insurance Median: $2,016 (165%)

Ins. Median: $2,016 (165% 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
Community Care Health	$333	27%
Molina Healthcare	$333 - $346	27%
Sierra Hpn	$333	27%
Caresource	$346	28%
United	$752 - $2,295	62%
Corvel	$1,520	124%
Olympus Medsave Usa	$1,600	131%
Sierra	$1,795	147%
Aetna	$1,937	158%
Hometown Health Providers	$2,016 - $2,339	165%
Cigna	$2,482	203%
Ambetter / Centene	$2,550	209%
Blue Cross Blue Shield	$3,072 - $3,839	251%
Multiplan	$3,500	286%
Health Services Coalition	$4,260	348%
Select Health	$4,882 - $5,307	399%

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 $X.
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 Mountainview Hospital 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.