CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Hillsboro Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,330
Cash Discount Price: $3,477
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Hillsboro Medical Center is $1,330. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,477. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.09x the Medicare baseline. Located in 335 Se 8Th Avenue, Hillsboro, OR.

Cash / Self-Pay

$3,477

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,330

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: $3,477 (284%)

Insurance Median: $1,330 (109%)

Cash: $3,477 (284% of Medicare)

Ins. Median: $1,330 (109% 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
Care Oregon	$519 - $1,570	42%
Intercommunity Health Network	$519 - $1,037	42%
Medicare (plans)	$519 - $1,570	42%
Kaiser Foundation Hospitals	$532 - $3,897	44%
Pacific Source	$532 - $3,423	44%
Community Health Plan Of Washington	$665 - $5,349	54%
Providence Health Plan	$665 - $1,858	54%
Samaritan Health Plan	$665 - $1,330	54%
Trillium	$665 - $1,330	54%
Humana	$685 - $1,410	56%
UnitedHealthcare	$705 - $4,479	58%
Aetna	$718 - $4,963	59%
Moda	$732 - $4,788	60%
Health Net Health Plan Of Oregon, Inc.	$765 - $3,530	63%
Tuality Health	$1,197 - $2,394	98%
Blue Cross Blue Shield	$1,753 - $3,506	143%
Cigna	$3,691	302%
First Choice	$4,279	350%
Coventry First Health	$4,547	372%
Molina Exchange	$5,349	438%

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 $3,477.
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 Hillsboro 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.