CMS Price Transparency Data

Colonoscopy with biopsy

Facility: University Hospitals Portage Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,790
Cash Discount Price: $2,441
vs. Medicare Baseline: 1.46x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at University Hospitals Portage Medical Center is $1,790. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,441. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.46x the Medicare baseline. Located in 6847 N Chestnut, Ravenna, OH.

Cash / Self-Pay

$2,441

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,790

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: $2,441 (200%)

Insurance Median: $1,790 (146%)

Cash: $2,441 (200% of Medicare)

Ins. Median: $1,790 (146% 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	$781 - $1,783	64%
Aetna	$1,093 - $3,602	89%
Blue Cross Blue Shield	$1,093 - $2,659	89%
Cigna	$1,093 - $1,822	89%
Devoted Health	$1,093	89%
Humana	$1,093	89%
Molina	$1,093	89%
Primetime Health Plan	$1,093	89%
Summacare	$1,093	89%
The Health Plan	$1,093 - $2,148	89%
UnitedHealthcare	$1,093 - $2,499	89%
Wellcare By Allwell	$1,093	89%
Paramount	$1,126	92%
Perennial Advantage Of Ohio	$1,148	94%
Valor Health Plans	$1,148	94%
Amish Aid Community Plan	$1,497	122%
Amish Church Fund And Workers Aid Plan	$1,497	122%
Buckeye Plain Ministries	$1,497	122%
Clarity	$1,562	128%
Jp Farley	$1,562	128%
Christian Healthcare Ministries	$1,627	133%
Immergrun	$1,627	133%
Sunrise Plain Communities	$1,627	133%
Aultcare	$1,790	146%
Ambetter / Centene	$1,968	161%
Caresource	$1,968	161%
Healthsmart	$2,115	173%
Ohio Health Choice	$2,115 - $2,929	173%
Medical Mutual Traditional/Health Ohio	$2,278	186%
Beech Street	$2,603 - $2,929	213%
Ohio Preferred Network	$2,603 - $2,929	213%
First Health	$2,701	221%
Century Health Network	$2,766	226%
Private Healthcare System	$2,798	229%
Configurenet	$2,929	240%
Fortified Provider Network	$2,929	240%
Multiplan	$2,929	240%

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 $2,441.
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 Portage 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.