CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Good Samaritan Hospital Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,395
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Good Samaritan Hospital Medical Center is $1,395. 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 1.14x the Medicare baseline. Located in 1000 Montauk Highway, West Islip, NY.
Cash / Self-Pay
Unavailable

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%)
Insurance Median: $1,395 (114%)
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

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Commercial Insurance Negotiated Rates

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

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Zadroga $419 34%
Affinity Health Plan $1,004 - $2,259 82%
Centerlight Healthcare $1,004 - $1,395 82%
Elderplan Inc. $1,004 - $1,395 82%
Emblem Health $1,004 - $3,902 82%
Fidelis Care New York $1,004 - $2,259 82%
Health First $1,004 - $3,139 82%
Health Plus $1,004 - $2,259 82%
Independent Health $1,004 - $1,395 82%
Medicaid / KanCare $1,004 82%
Mvp Health Plans $1,004 - $2,656 82%
Senior Whole Health $1,004 - $1,395 82%
UnitedHealthcare $1,004 - $4,122 82%
Brighton $1,200 - $3,547 98%
Blue Cross Blue Shield $1,367 - $4,122 112%
Aetna $1,395 - $4,731 114%
Centers Plan For Healthy Living $1,395 114%
Healthspring $1,395 114%
Liberty Health $1,395 114%
Longevity Health Plan $1,395 114%
Medicare (plans) $1,395 - $1,465 114%
Orthonet - Uniformed Services Family Health Plan $1,395 114%
Pmc $1,395 114%
Tricare $1,395 114%
Universal Healthcare $1,395 114%
Us Family Health Plan $1,395 114%
Veterans Affairs $1,395 114%
Humana $1,423 116%
Agewell New York $1,444 118%
Partners Health Plan $1,465 120%
Wellcare Health Plan Inc $1,535 126%
Apwu $2,656 217%
Centivo $2,656 - $3,685 217%
Cigna $2,656 217%
Daniel H Cook $2,656 217%
Nalc $2,656 217%
Samba $2,656 217%
Surest $3,641 298%
American Plan Administrators $3,902 319%
Amerihealth Administrators $3,902 319%
Benefit Services $3,902 319%
Ghi Cbp Ny City Employee Alternate $3,902 319%
International Benefit Administrator $3,902 319%
Ultra Benefits Inc. $3,902 319%
Local 1199 $3,945 323%
Self Pay $4,122 337%
Mail Handlers Benefit Plan $4,731 387%
Meritain Health $4,731 387%
Nippon Life Insurance Company Of America $4,731 387%
Salvation Army $4,731 387%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Montauk Highway, West Islip, NY 11795
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals