CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Arnot Ogden Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $843
Cash Discount Price: $500
vs. Medicare Baseline: 0.69x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Arnot Ogden Medical Center is $843. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $500. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.69x the Medicare baseline. Located in 600 Roe Avenue, Elmira, NY.

Cash / Self-Pay

$500

Average discount available for prompt cash payment at this facility.

Insurance Median

$843

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: $500 (41%)

Insurance Median: $843 (69%)

Cash: $500 (41% of Medicare)

Ins. Median: $843 (69% 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
Empire	$171 - $390	14%
Amerihealth	$225 - $320	18%
Blue Cross Blue Shield	$265 - $2,129	22%
Geisinger	$322 - $2,585	26%
UnitedHealthcare	$382 - $3,199	31%
Aetna	$404 - $3,243	33%
Emblem/Ghi	$487 - $3,910	40%
Humana	$498 - $3,998	41%
Fidelis	$842 - $1,345	69%
Icircle	$842	69%

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 $500.
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 Arnot Ogden 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.