CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Bertrand Chaffee Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $338
Cash Discount Price: $277
vs. Medicare Baseline: 0.28x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Bertrand Chaffee Hospital is $338. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $277. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.28x the Medicare baseline. Located in 224 East Main Street, Springville, NY.

Cash / Self-Pay

$277

Average discount available for prompt cash payment at this facility.

Insurance Median

$338

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: $277 (23%)

Insurance Median: $338 (28%)

Cash: $277 (23% of Medicare)

Ins. Median: $338 (28% 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
Blue Cross Blue Shield	$100 - $1,949	8%
Champva	$186 - $406	15%
Medicare (plans)	$186 - $406	15%
Tricare	$186 - $406	15%
UnitedHealthcare	$186 - $406	15%
Iha Encompass 65	$187	15%
Private Pay	$266 - $287	22%
Aetna	$313 - $406	26%
American Progressive Ins.	$313 - $338	26%
Cigna	$313 - $406	26%
Commercial / Misc	$313 - $338	26%
Global Excel Mgt	$313 - $338	26%
Guardian Life Ins. Co.	$313 - $338	26%
Iha	$313	26%
Iha Custom Coverage	$313	26%
Mvp Commercial	$313 - $338	26%
No Amer Meritian Health	$313 - $338	26%
No-Fault	$313 - $338	26%
Nova Healthcare	$313 - $338	26%
Advantra-Mcr Advantage	$406	33%
Centers Plan Hlty Living	$406	33%
Ctrs Plan For Hlthy Livng	$406	33%
Geisinger Health Plan	$406	33%
Humana	$406	33%
Lifetime Benefits	$406	33%
Mutual Of Omaha	$406	33%
Optimum Healthcare - Mcr	$406	33%
Todays Option - Amer Prog	$406	33%
United Hc Mcr Solutions	$406	33%
Wellcare	$406	33%
Univera Healthcare	$864	71%
Univera Senior Choice	$864	71%
Senior Blue - Bc	$1,409	115%

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 $277.
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 Bertrand Chaffee 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.