CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Ohio State University State Health System

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,394
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Ohio State University State Health System is $1,394. 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 1.14x the Medicare baseline. Located in 410 West 10Th Avenue, Columbus, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,394

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: $1,394 (114%)
Ins. Median: $1,394 (114% 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Osu Health Plan $882 - $1,422 72%
Ohio Ppo $1,061 - $1,275 87%
Aetna $1,129 - $2,287 92%
Blue Cross Blue Shield $1,129 - $3,618 92%
Medicare (plans) $1,129 - $1,219 92%
Medigold $1,129 92%
Mmo $1,129 - $3,732 92%
Molina $1,129 - $1,885 92%
Upper Ohio Valley $1,129 - $1,878 92%
Humana $1,151 - $1,309 94%
Odrc $1,157 95%
Buckeye Community $1,163 - $1,750 95%
Caresource $1,185 - $1,750 97%
Healthspan $1,185 - $1,366 97%
Ohiohealth $1,849 - $2,134 151%
Lifetrac $1,935 158%
Frontpath $2,276 186%
Multiplan $2,276 186%
United $2,391 196%
Healthsmart $2,560 209%
Cigna $2,711 222%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 410 West 10Th Avenue, Columbus, OH 43210
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals