CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Mid-Columbia Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,377
Cash Discount Price: $952
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Mid-Columbia Medical Center is $1,377. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $952. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.13x the Medicare baseline. Located in 1700 E 19Th Street, The Dalles, OR.

Cash / Self-Pay

$952

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,377

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: $952 (78%)

Insurance Median: $1,377 (113%)

Cash: $952 (78% of Medicare)

Ins. Median: $1,377 (113% 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
Blue Cross Blue Shield	$173 - $8,258	14%
Community Hp Mcr Adv - All Plans	$173 - $1,425	14%
Molina Mcr Adv	$173 - $1,425	14%
Tricare	$173 - $1,425	14%
Va Ccn Triwest - All Plans	$173 - $1,425	14%
Healthnet Mcr Adv	$177 - $1,453	14%
Humana	$179 - $1,496	15%
Moda Mcr Adv	$179 - $1,425	15%
Devoted Mcr Adv - All Plans	$187 - $2,797	15%
Employee Health Plan - All Plans	$191 - $2,564	16%
Molina - All Other Plans	$191 - $1,567	16%
Healthnet - All Other Plans	$278	23%
Cigna	$290 - $2,440	24%
Multiplan/Phcs - All Plans	$295 - $2,460	24%
Aetna	$329 - $2,391	27%
Coventry - All Plans	$359 - $2,331	29%
First Choice - All Plans	$365 - $2,460	30%
Providence Ppo - All Plans	$382 - $2,460	31%
Moda Health Plan - All Other Plans	$400 - $1,709	33%
Molina Mcaid	$716 - $1,347	59%
Norocor - All Plans	$1,295	106%
Amerigroup Mcaid - All Plans	$1,347 - $1,377	110%
Coordinated Care Mcaid - All Plans	$1,347 - $1,377	110%
UnitedHealthcare	$1,347 - $2,460	110%
Healthscape - All Plans	$2,072	169%
First Health - All Plans	$2,202	180%
Pacific Source - All Plans	$2,383	195%
Trpn - Three Rivers - All Plans	$2,460	201%
Ahp - Americas Hlth Plan - All Plans	$2,512	205%

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 $952.
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 Mid-Columbia Medical Center 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.