CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Ohio Valley Surgical Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,124
  • Cash Discount Price: $4,367
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Ohio Valley Surgical Hospital is $1,124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,367. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.92x the Medicare baseline. Located in 100 West Main Street, Springfield, OH.
Cash / Self-Pay
$4,367

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,124

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: $4,367 (357%)
Insurance Median: $1,124 (92%)
Cash: $4,367 (357% of Medicare)
Ins. Median: $1,124 (92% 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
Aetna $501 - $1,124 41%
Geha $501 41%
Genworth $501 41%
Mail Handlers $501 41%
Meritain $501 41%
Meritain Heatlh $501 41%
Mhbp $501 41%
Ngs Coresource $501 41%
Nippon Life $501 41%
Pacific Source $501 41%
Personify Health $501 41%
Aarp $1,124 92%
Aarp Supplemental $1,124 92%
American Continental Insurance $1,124 92%
American Continental Life $1,124 92%
American Republic $1,124 92%
American Retirement $1,124 92%
Aultcare Primetime Health Plan $1,124 92%
Bankers Fidelity $1,124 92%
Bankers Life And Casualty $1,124 92%
Blue Cross Blue Shield $1,124 - $7,170 92%
Central States $1,124 92%
Champus $1,124 92%
Cigna $1,124 - $1,763 92%
Communicare Advantage $1,124 92%
Everest $1,124 92%
Gateway Health Plan $1,124 92%
Humana $1,124 92%
Medicare (plans) $1,124 - $4,367 92%
Medigold $1,124 92%
Mmoh $1,124 - $4,586 92%
Molina $1,124 92%
Molina Dual Mcr $1,124 92%
Molina Marketplace $1,124 92%
Molina Dual Mcr $1,124 92%
Molina Mcr $1,124 92%
Molina Mcr Mcd $1,124 92%
Molina Mcr+Mcd $1,124 92%
Patient No Pay $1,124 92%
Prosperity Supplement $1,124 92%
Self Pay Imaging $1,124 92%
UnitedHealthcare $1,124 - $2,869 92%
Wellcare By Allwell $1,124 92%
Wraparound Pl Supp $1,124 92%
The Health Plan $1,180 97%
Devoted Health $1,219 100%
Employer Direct $1,292 106%
Caresource $1,686 138%
Caresourse $1,686 138%
Medicaid / KanCare $1,686 138%
Healthgram $1,763 144%
Nalc $1,763 144%
Samba $1,763 144%
Sbma $1,763 144%
Unified Group $1,763 144%
Mmoh (Supermed) $3,385 277%
Mmo Cin. Hmo $4,586 375%
Luminare Health $6,551 536%
Medben $6,551 536%
Ohio Health $6,551 536%
Preferred Health $6,551 536%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 West Main Street, Springfield, OH 45502
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals