CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Guthrie Cortland Regional Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,395
Cash Discount Price: $2,070
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Guthrie Cortland Regional Medical Center is $1,395. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,070. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.14x the Medicare baseline. Located in 134 Homer Avenue, Cortland, NY.

Cash / Self-Pay

$2,070

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,395

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: $2,070 (169%)

Insurance Median: $1,395 (114%)

Cash: $2,070 (169% of Medicare)

Ins. Median: $1,395 (114% 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
Pa Health And Wellness	$243 - $353	20%
Amerihealth	$293 - $1,539	24%
Geisinger	$296 - $1,395	24%
Aetna	$318 - $1,539	26%
Upmc	$333 - $1,395	27%
Blue Cross Blue Shield	$532 - $4,346	44%
Health Partners	$728 - $1,295	60%
Fidelis	$795 - $2,587	65%
UnitedHealthcare	$812 - $4,432	66%
Mvp	$1,073 - $5,339	88%
Emblem	$1,083 - $4,272	89%
Cdphp	$1,292 - $5,339	106%
Freedom Blue	$1,292	106%
Tricare	$1,292 - $1,494	106%
Wellcare	$1,292 - $5,339	106%
Humana	$1,395 - $1,547	114%
Icircle	$1,395 - $2,587	114%
Fidelis Essential	$1,788 - $2,587	146%

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 $2,070.
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 Guthrie Cortland Regional 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.