CMS Price Transparency Data

Colonoscopy with biopsy

Facility: University of Cincinnati Medical Center, LLC

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,861
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.52x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at University of Cincinnati Medical Center, LLC is $1,861. 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 1.52x the Medicare baseline. Located in 3188 Bellevue Avenue, Cincinnati, OH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,861

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: $1,861 (152%)

Ins. Median: $1,861 (152% 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
Aetna	$1,186 - $3,322	97%
Caresource	$1,198 - $1,542	98%
Perennial Advantage	$1,210	99%
Buckeye Health Plan	$1,246 - $1,661	102%
Communicare Advantage	$1,305	107%
Blue Cross Blue Shield	$1,531 - $3,468	125%
Humana	$1,602	131%
Oscar	$2,062 - $3,417	169%
Cincinnati Public Library	$2,242	183%
UnitedHealthcare	$4,922	403%

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 $X.
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 of Cincinnati Medical Center, LLC 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.