CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Alliancehealth Durant

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,675
Cash Discount Price: $3,013
vs. Medicare Baseline: 1.37x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Alliancehealth Durant is $1,675. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,013. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.37x the Medicare baseline. Located in 1800 University Boulevard, Durant, OK.

Cash / Self-Pay

$3,013

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,675

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: $3,013 (246%)

Insurance Median: $1,675 (137%)

Cash: $3,013 (246% of Medicare)

Ins. Median: $1,675 (137% 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
Veterans Eval Services	$381	31%
Aetna	$1,078 - $18,834	88%
Humana	$1,078 - $1,136	88%
Medicaid / KanCare	$1,078	88%
Medicare (plans)	$1,136	93%
Department Of Veterans Affairs	$1,154	94%
Node Hospice Non Par Agree	$1,154	94%
Node Va	$1,154	94%
Tricare	$1,154	94%
UnitedHealthcare	$1,154 - $7,307	94%
Blue Cross Blue Shield	$1,170 - $3,691	96%
Node Sterling Mcr Adv	$1,170	96%
Node Us Dept Of Labor	$1,443	118%
Prime Health Work Comp Ok	$1,909	156%
Ok Work Comp	$1,968	161%
Healthchoice	$2,240	183%
Self Pay	$3,516	288%
Cigna	$6,755	553%
Healthcare Highways	$8,362	684%
Customer Linx	$15,067	1232%
Phcs Savility	$17,578	1438%
First Health	$18,834	1541%
Healthsmart	$19,085	1561%
Multiplan Complementary	$20,089	1643%
Multiplan Primary	$20,089	1643%
Prime Health Services	$20,089	1643%
One Health Plan	$21,345	1746%
Preferred Community Choice Ppo	$21,345	1746%
Comprehensive Medical Care	$22,600	1849%

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 $3,013.
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 Alliancehealth Durant 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.