CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Christ Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,089
Cash Discount Price: $3,378
vs. Medicare Baseline: 0.89x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Christ Hospital is $1,089. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,378. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.89x the Medicare baseline. Located in 2139 Auburn Avenue, Cincinnati, OH.

Cash / Self-Pay

$3,378

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,089

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: $3,378 (276%)

Insurance Median: $1,089 (89%)

Cash: $3,378 (276% of Medicare)

Ins. Median: $1,089 (89% 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	$73 - $4,982	6%
Blue Cross Blue Shield	$826 - $3,617	68%
Caresource [2031]	$826 - $5,265	68%
Humana	$826 - $3,378	68%
Medicaid / KanCare	$826 - $984	68%
Aetna	$1,089 - $3,378	89%
Allied Benefits [2163]	$1,089	89%
Ambetter / Centene	$1,089	89%
Buckeye Mycare Dual [2171]	$1,089	89%
Cigna	$1,089	89%
Custom Design Benefits - True Cost [3004]	$1,089	89%
First Health [2041]	$1,089	89%
Medben [2222]	$1,089	89%
Medicare (plans)	$1,089	89%
Medigold Ppo [2204]	$1,089	89%
Meridian [2185]	$1,089	89%
Meritain Health [2224]	$1,089	89%
Other Exchange Plan [9992]	$1,089	89%
Perennial [4200]	$1,089	89%
Poppins Health [2299]	$1,089	89%
Medical Mutual [2054]	$3,210	263%
Western And Southern [2076]	$3,210	263%
Amerihealth Caritas [2230]	$3,378	276%
Buckeye Community Health [2028]	$3,378	276%
Life Synch [2080]	$3,378	276%
Geha [2168]	$4,982	408%
Golden Rule [2161]	$4,982	408%
United Medical Resources [2104]	$4,982	408%

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 $3,378.
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 Christ 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.