CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Bailey Medical Center, LLC

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $3,361
Cash Discount Price: $1,483
vs. Medicare Baseline: 2.75x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Bailey Medical Center, LLC is $3,361. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,483. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 2.75x the Medicare baseline. Located in 10502 North 110Th East Avenue, Owasso, OK.

Cash / Self-Pay

$1,483

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,361

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: $1,483 (121%)

Insurance Median: $3,361 (275%)

Cash: $1,483 (121% of Medicare)

Ins. Median: $3,361 (275% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 275% of the Medicare baseline (a markup of 175%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Healthcare Highways [2210]	$1,236 - $1,359	101%
Hooray Health [8000]	$1,236	101%
Oncology Patient Assistance Programs [2295]	$1,236	101%
Oscar Insurance Company [7005]	$1,236	101%
Osma Health Network [2345]	$1,236	101%
Healthscope Benefits [2290]	$1,308	107%
UnitedHealthcare	$1,308	107%
Resource One Administrators [2815]	$1,359	111%
Web Tpa [2115]	$1,359	111%
The Kempton Group Administrators [2905]	$2,224	182%
Cigna	$2,328	190%
Healthpartners [1500]	$2,328	190%
National Association Of Letter Carriers [1695]	$2,328	190%
Pba [1775]	$2,328	190%
First Health [1375]	$2,501 - $4,053	205%
Medica [2910]	$2,501	205%
Multiplan [1680]	$2,501 - $4,053	205%
Healthcare Solutions [1485]	$2,818	230%
Community Care [1290]	$3,905	319%
Employee Benefit Management Services [2445]	$3,905	319%
Fmh Benefit Services [1390]	$3,905	319%
Group Resources [1455]	$3,905	319%
Phcs [1780]	$3,905 - $4,053	319%
Gilsbar [1425]	$4,053	332%
Healthcost Solutions [2415]	$4,053	332%
Healthfirst [2395]	$4,053	332%
Healthnet [1495]	$4,053	332%
Hometown Health [2155]	$4,053	332%
Mayo Clinic Health Solutions [2280]	$4,053	332%
Mutual Of Omaha [1685]	$4,053	332%
New Era Life Insurance Company [1705]	$4,053	332%
Pan American Life Insurance Co [1770]	$4,053	332%
Planned Administrators Inc [2360]	$4,053	332%
Trustmark [2030]	$4,053	332%
Universal Fidelity [2085]	$4,053	332%
Healthsmart [1505]	$4,202	344%
Pending Ssi [1616]	$4,943	404%

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 $1,483.
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 Bailey Medical Center, LLC 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.