CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Novant Health Hilton Head Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,146
Cash Discount Price: $833
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Novant Health Hilton Head Medical Center is $1,146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $833. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.94x the Medicare baseline. Located in 25 Hospital Center Blvd, Hilton Head Island, SC.

Cash / Self-Pay

$833

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,146

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: $833 (68%)

Insurance Median: $1,146 (94%)

Cash: $833 (68% of Medicare)

Ins. Median: $1,146 (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
Humana	$822 - $1,113	67%
Molina	$822 - $1,948	67%
Select Health	$822 - $2,493	67%
Blue Cross Blue Shield	$833 - $3,376	68%
Absolute Total Care	$863 - $1,836	71%
Aetna	$1,113	91%
Devoted Health Plan	$1,113	91%
UnitedHealthcare	$1,113 - $12,538	91%
Cigna	$1,146	94%
Clover Insurance Company	$1,157	95%

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 $833.
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 Novant Health Hilton Head 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.