CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Uhhs Memorial Hospital of Geneva

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,729
Cash Discount Price: $1,995
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Uhhs Memorial Hospital of Geneva is $1,729. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,995. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.41x the Medicare baseline. Located in 870 West Main Street, Geneva, OH.

Cash / Self-Pay

$1,995

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,729

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: $1,995 (163%)

Insurance Median: $1,729 (141%)

Cash: $1,995 (163% of Medicare)

Ins. Median: $1,729 (141% 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
Aetna	$532 - $3,602	44%
Blue Cross Blue Shield	$532 - $2,538	44%
Cigna	$532 - $2,526	44%
Devoted Health	$532	44%
Humana	$532	44%
Medical Mutual Of Ohio	$532 - $2,660	44%
Molina	$532	44%
Primetime Health Plan	$532	44%
Summacare	$532 - $1,357	44%
The Health Plan	$532 - $1,756	44%
UnitedHealthcare	$532 - $2,251	44%
Wellcare By Allwell	$532	44%
Paramount	$548	45%
Perennial Advantage Of Ohio	$559	46%
Valor Health Plans	$559	46%
Ambetter / Centene	$958	78%
Caresource	$958	78%
Amish Aid Community Plan	$1,224 - $1,385	100%
Amish Church Fund And Workers Aid Plan	$1,224 - $1,385	100%
Buckeye Plain Ministries	$1,224 - $1,385	100%
Jp Farley	$1,250	102%
Clarity	$1,277	104%
Christian Healthcare Ministries	$1,330	109%
Immergrun	$1,330	109%
Sunrise Plan Communities	$1,330	109%
Aultcare	$1,463	120%
Healthsmart	$1,729	141%
Ohio Health Choice	$1,729 - $2,394	141%
University Health Employee Plan (Contigo)	$1,857	152%
Beech Street	$2,128 - $2,394	174%
Ohio Preferred Network	$2,128 - $2,394	174%
First Health	$2,208	181%
Century Health Network	$2,261	185%
Private Healthcare System	$2,288	187%
Configurenet	$2,394	196%
Fortified Provider Network	$2,394	196%
Multiplan	$2,394	196%

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 $1,995.
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 Uhhs Memorial Hospital of Geneva 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.