CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Prisma Health Greer Memorial Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,152
Cash Discount Price: $2,439
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Prisma Health Greer Memorial Hospital is $1,152. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,439. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.94x the Medicare baseline. Located in 1413 John B White Sr Blvd Suite D, Spartanburg, SC.

Cash / Self-Pay

$2,439

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,152

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: $2,439 (199%)

Insurance Median: $1,152 (94%)

Cash: $2,439 (199% of Medicare)

Ins. Median: $1,152 (94% 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 Choice Healthplan Of Sc	$294 - $1,093	24%
Medicaid / KanCare	$320 - $1,174	26%
Bluechoice Healthplan Of Sc	$333 - $2,727	27%
Molina	$340 - $1,152	28%
Select Health	$340 - $1,152	28%
Humana	$343 - $1,197	28%
Tricare	$404 - $1,034	33%
Choicecare Network	$412 - $3,189	34%
Wellpath Select Inc	$554 - $1,419	45%
Sc Workers Compensation	$565 - $1,448	46%
Medicare (plans)	$587 - $1,086	48%
Blue Cross Blue Shield	$839 - $2,599	69%
Prisma Health Seniorcare Pace-Upstate	$904	74%
Celtic Insurance Company	$1,014	83%
Veterans Administration	$1,034	85%
Cigna	$1,069 - $3,002	87%
Liberty Advantage	$1,069	87%
Promise Health Plan	$1,071	88%
UnitedHealthcare	$1,071 - $5,237	88%
Absolute Total Care Prime	$1,086	89%
Aetna	$1,086 - $3,302	89%
Windsor Health Plan	$1,086	89%
Value Options	$1,876	153%
Preferred Care, Inc	$2,626	215%
Chp Direct Supermed Network	$2,701	221%
Medcost	$2,776	227%
Atlantic Packaging	$2,814	230%
Aps Healthcare Bethesda Inc	$3,002	246%
Medcost Preferred	$3,077	252%
Multiplan	$3,339	273%
Companion Benefit Alternatives	$3,752	307%
Miscellaneous	$3,752	307%
Self Pay	$3,752	307%

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 $2,439.
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 Prisma Health Greer Memorial Hospital 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.