CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Adventist Health Portland

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $2,807
  • Cash Discount Price: $1,456
  • vs. Medicare Baseline: 2.30x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Adventist Health Portland is $2,807. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,456. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 2.30x the Medicare baseline. Located in 10123 Se Market Street, Portland, OR.
Cash / Self-Pay
$1,456

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,807

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: $1,456 (119%)
Insurance Median: $2,807 (230%)
Cash: $1,456 (119% of Medicare)
Ins. Median: $2,807 (230% 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 230% of the Medicare baseline (a markup of 130%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 Resources - All Plans $1,023 84%
Ods - All Plans $1,064 87%
Care Oregon - All Plans $1,131 93%
Kaiser Mcr Adv $1,330 109%
Humana $1,357 - $1,410 111%
Moda Mcr Adv $1,410 115%
UnitedHealthcare $1,410 - $2,731 115%
Providence Hp - All Plans $1,475 121%
Healthnet Mcr Adv $1,530 125%
Workers Comp $1,575 129%
Bc Premera First - All Plans $2,276 186%
Ah Employee Health Plan - All Plans $2,394 196%
Regence Ohsu Plus $2,494 204%
Moda Conn Oebb/Syn Pebb $2,660 218%
Worldventure - All Plans $2,731 223%
Regence - All Other Plans $2,771 227%
Regence Preferred Mcr Adv $2,807 230%
Regence Mcr Adv $2,915 238%
Pacific Source Comm - All Plans $3,004 246%
Moda Affinity - All Other Plans $3,059 250%
First Choice - All Plans $3,154 258%
Multiplan - All Plans $3,413 279%
Phcs - All Plans $3,413 279%
Kaiser - All Other Plans $3,469 284%
National Provider Network - All Plans $4,005 328%
Health Payors Organization Ltd- All Plans $4,096 335%
Moda Select $4,163 341%
Moda Connexus $4,709 385%
Moda Synergy $4,981 407%
Healthnet Hmo/Pos - All Other Plans $5,476 448%
Healthnet Epo/Pos/Ppo $5,624 460%
First Health-Coventry - All Plans $8,025 656%
Cigna $8,086 661%
Moda Ohsu Ppo/Epo/Hmc $8,192 670%
Aetna $20,117 1645%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10123 Se Market Street, Portland, OR 97216
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals