CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Cleveland Clinic

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,093
  • Cash Discount Price: $3,158
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Cleveland Clinic is $1,093. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,158. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.89x the Medicare baseline. Located in 9500 Euclid Avenue, Cleveland, OH.
Cash / Self-Pay
$3,158

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,093

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: $3,158 (258%)
Insurance Median: $1,093 (89%)
Cash: $3,158 (258% of Medicare)
Ins. Median: $1,093 (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.

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
Summacare $122 - $2,317 10%
Aetna $188 - $4,858 15%
Blue Cross Blue Shield $188 - $4,126 15%
Devoted Health $188 - $1,093 15%
Humana $188 - $4,129 15%
The Health Plan $188 - $2,915 15%
United $188 - $6,112 15%
UnitedHealthcare $188 - $3,255 15%
Upmc $188 - $2,915 15%
Valor $188 - $1,093 15%
Cigna $193 - $3,886 16%
Communicare $197 - $1,148 16%
Perennial Health $203 - $1,180 17%
Pphp $203 - $1,202 17%
Zing Health $206 - $1,202 17%
Paramount $209 - $957 17%
Buckeye $213 - $976 17%
Caresource $213 - $929 17%
Amerihealth $223 18%
Molina $223 - $976 18%
Cc Ehp $357 - $3,031 29%
Oscar $409 - $1,868 33%
Mmo $579 - $4,658 47%
Ohcp $596 - $2,361 49%
Ohio Healthy $612 - $3,401 50%
Aultcare $658 - $2,380 54%
Amish Community Aid Plan $689 - $2,429 56%
Omas $766 - $2,429 63%
Healthsmart $842 - $2,672 69%
Phphi $919 - $2,915 75%
Clarity Health $995 - $3,158 81%
United Bh $1,022 84%
Gms $1,072 - $3,401 88%
Quality Care Partners $1,072 - $3,401 88%
Consociate Health $1,148 - $3,644 94%
Multiplan $1,378 - $4,372 113%
Three Rivers $1,378 - $4,372 113%
Usa Managed Care $1,378 113%
Php $2,915 238%
Medical Benefit Corp $3,401 278%
Parkview Health Plan $3,401 278%
Community Health Alliance $3,886 318%
Frontpath $4,372 358%
Managed Care Services $4,372 358%
Tertiary Care Network $4,372 358%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9500 Euclid Avenue, Cleveland, OH 44195
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals