CMS Price Transparency Data

Colonoscopy with biopsy

Facility: East Liverpool City Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,352
Cash Discount Price: $1,126
vs. Medicare Baseline: 1.11x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at East Liverpool City Hospital is $1,352. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,126. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.11x the Medicare baseline. Located in 425 West 5Th Street, East Liverpool, OH.

Cash / Self-Pay

$1,126

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,352

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: $1,126 (92%)

Insurance Median: $1,352 (111%)

Cash: $1,126 (92% of Medicare)

Ins. Median: $1,352 (111% 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
UnitedHealthcare	$1,104 - $1,598	90%
Blue Cross Blue Shield	$1,127 - $1,598	92%
Buckeye Community Health Plan	$1,127 - $1,598	92%
Health America	$1,127	92%
Medical Mutual Of Oh	$1,127	92%
Medicare (plans)	$1,127	92%
Molina	$1,127 - $1,598	92%
Tricare	$1,127	92%
Care Source	$1,160 - $1,598	95%
Devoted Health	$1,183	97%
Communicare	$1,205	99%
Valor Health Plan	$1,205	99%
Perennial	$1,239	101%
Naphcare	$1,352	111%
Employer Direct Healthcare	$1,577	129%
Amerihealth Caritas	$1,598	131%
Medicaid / KanCare	$1,598	131%
Multiplan (Fka Private Healthcare Systems)	$1,598	131%
Paramount	$1,598	131%
Provider Select	$1,598	131%
Standard Eapg Logic	$1,598	131%
Three Rivers	$1,598	131%
Worker Compensation	$1,598	131%

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 $1,126.
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 East Liverpool City 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.