CMS Price Transparency Data

Colonoscopy with biopsy

Facility: University Hospitals Samaritan Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,940
Cash Discount Price: $1,732
vs. Medicare Baseline: 1.59x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at University Hospitals Samaritan Medical Center is $1,940. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,732. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.59x the Medicare baseline. Located in 1025 Center St, Ashland, OH.

Cash / Self-Pay

$1,732

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,940

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: $1,732 (142%)

Insurance Median: $1,940 (159%)

Cash: $1,732 (142% of Medicare)

Ins. Median: $1,940 (159% 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
Medical Mutual Of Ohio	$817 - $2,288	67%
Aetna	$1,020 - $1,981	83%
Blue Cross Blue Shield	$1,020 - $2,085	83%
Cigna	$1,020 - $2,129	83%
Devoted Health	$1,020	83%
Humana	$1,020	83%
Molina	$1,020	83%
Primetime Health Plan	$1,020	83%
Summacare	$1,020 - $2,101	83%
The Health Plan	$1,020 - $2,032	83%
UnitedHealthcare	$1,020 - $2,129	83%
Wellcare By Allwell	$1,020	83%
Paramount	$1,051	86%
Amish Aid Community Plan	$1,062 - $1,385	87%
Amish Church Fund And Workers Aid Plan	$1,062 - $1,385	87%
Buckeye Plain Ministries	$1,062 - $1,385	87%
Perennial Advantage Of Ohio	$1,071	88%
Valor Health Plans	$1,071	88%
Christian Healthcare Ministries	$1,154	94%
Immergrun	$1,154	94%
Sunrise Plain Communities	$1,154	94%
Medical Mutual Traditional/Health Ohio	$1,616	132%
University Health Employee Plan (Contigo)	$1,786	146%
Ambetter / Centene	$1,837	150%
Caresource	$1,837	150%
Beech Street	$1,847 - $2,078	151%
Ohio Preferred Network	$1,847 - $2,078	151%
First Health	$1,916	157%
Century Health Network	$1,963	161%
Ohio Health Choice	$1,963 - $2,078	161%
Private Healthcare System	$1,986	162%
Aultcare	$2,078	170%
Clarity	$2,078	170%
Configurenet	$2,078	170%
Fortified Provider Network	$2,078	170%
Healthsmart	$2,078	170%
Jp Farley	$2,078	170%
Multiplan	$2,078	170%

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 $1,732.
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 University Hospitals Samaritan 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.