CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Fisher-Titus Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $473
Cash Discount Price: $697
vs. Medicare Baseline: 0.39x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Fisher-Titus Hospital is $473. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $697. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.39x the Medicare baseline. Located in 272 Benedict Avenue, Norwalk, OH.

Cash / Self-Pay

$697

Average discount available for prompt cash payment at this facility.

Insurance Median

$473

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: $697 (57%)

Insurance Median: $473 (39%)

Cash: $697 (57% of Medicare)

Ins. Median: $473 (39% 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	$158 - $1,106	13%
Martin'S Point	$160 - $188	13%
Humana	$169 - $203	14%
Blue Cross Blue Shield	$188 - $5,883	15%
Buckeye	$188 - $1,106	15%
Caresource	$188 - $1,106	15%
Devoted	$188	15%
Medical Mutual Of Ohio	$188 - $1,106	15%
Medigold	$188	15%
Meridan	$188	15%
Paramount	$188 - $1,106	15%
Perennial Advantage	$188 - $1,161	15%
Summacare	$188 - $1,106	15%
UnitedHealthcare	$188 - $1,128	15%
Zinghealth	$191	16%
Sidecar	$192 - $2,371	16%
Valor Health	$193 - $1,139	16%
Gateway	$197	16%
Perennial	$197	16%
Wellcare	$197 - $1,106	16%
Health Scope	$225	18%
Emerald Health	$235 - $993	19%
Frontpath	$244	20%
Ohio Health Choice	$244 - $922	20%
Cigna	$263 - $819	22%
Clarity Health	$263	22%
Multiplan	$263 - $922	22%
Coresource	$264	22%
First Health	$264 - $922	22%
Health Ohio Network	$282 - $717	23%
Tricare	$394 - $819	32%
Claimsdoc	$420 - $819	34%
Healthscope	$478 - $932	39%
Amerihealth	$565	46%
Molina	$565	46%
Zing Health	$1,106	90%

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 $697.
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 Fisher-Titus Hospital 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.