CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Akron General Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $703
Cash Discount Price: $727
vs. Medicare Baseline: 0.58x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Akron General Medical Center is $703. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $727. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.58x the Medicare baseline. Located in 1 Akron General Avenue, Akron, OH.

Cash / Self-Pay

$727

Average discount available for prompt cash payment at this facility.

Insurance Median

$703

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: $727 (59%)

Insurance Median: $703 (58%)

Cash: $727 (59% of Medicare)

Ins. Median: $703 (58% 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
Summacare	$122 - $1,089	10%
Aetna	$188 - $1,531	15%
Blue Cross Blue Shield	$188 - $2,904	15%
Humana	$188 - $1,089	15%
Oscar	$188 - $409	15%
The Health Plan	$188 - $1,128	15%
United	$188 - $4,831	15%
UnitedHealthcare	$188 - $1,089	15%
Valor	$188 - $1,089	15%
Communicare	$197	16%
Buckeye	$203 - $738	17%
Pphp	$203 - $1,198	17%
Zing Health	$206 - $1,198	17%
Caresource	$213 - $738	17%
Amerihealth	$223 - $812	18%
Molina	$223 - $775	18%
Aultcare	$246	20%
Cigna	$269 - $1,122	22%
Ohcp	$275 - $596	22%
Omas	$353 - $766	29%
Phphi	$424 - $919	35%
Mmo	$459 - $2,475	38%
Gms	$494 - $1,072	40%
Consociate Health	$530 - $1,148	43%
Multiplan	$635 - $1,378	52%
United Bh	$782	64%
Upmc	$1,020	83%
Perennial Health	$1,177	96%

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 $727.
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 Akron General 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.