CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Prisma Health Baptist

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,326
  • Cash Discount Price: $2,439
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Prisma Health Baptist is $1,326. 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 1.08x the Medicare baseline. Located in 1330 Taylor at Marion St, Columbia, SC.
Cash / Self-Pay
$2,439

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,326

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: $1,326 (108%)
Cash: $2,439 (199% of Medicare)
Ins. Median: $1,326 (108% 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.

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
Medicaid / KanCare $578 - $1,504 47%
UnitedHealthcare $578 - $7,650 47%
Promise Health Plan Contracted [2401] $579 - $2,251 47%
Bob Jones Univ-Pai [821] $789 - $1,249 65%
Blue Cross Blue Shield $833 - $2,080 68%
Planned Administrators [820] $833 68%
Scdc-Sc Dept Of Corrections [7232] $833 68%
Prisma Health Seniorcare Pace - Midlands [5400] $870 71%
Prisma Health Seniorcare Pace-Upstate [5200] $870 71%
Tricare $1,091 89%
Cigna $1,151 - $2,604 94%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $1,151 94%
Humana $1,151 - $2,814 94%
Medicare (plans) $1,151 - $1,209 94%
Triwest Healthcare Alliance Vcp [902] $1,151 94%
Va Community Care Network-Vaccn [903] $1,151 94%
Aetna $1,209 - $2,964 99%
Healthy Conn Prime-First Choice Vip Care [5300] $1,209 99%
Healthy Conn Prime-Molina Healthcare [5330] $1,209 99%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $1,209 99%
Orangeburg Senior Helping Center Pace [5401] $1,501 123%
Workers Comp [600] $1,611 132%
Bluechoice [810] $2,080 - $3,544 170%
Ambetter / Centene $2,118 173%
Meritain Health Contracted [2200] $2,401 - $2,964 196%
Evernorth Behavioral Contracted [2982] $2,604 213%
Preferred Administrators Contracted [2839] $2,626 215%
Medcost [2940] $2,776 - $3,114 227%
Atlantic Packaging Contracted [4833] $2,814 230%
Nippon [2300] $2,964 242%
Aps Healthcare System [2981] $3,002 246%
Multiplan/Phcs Contracted [2950] $3,339 273%
Vsp Vision Care [2986] $3,377 276%
First Health Contracted [2952] $3,489 285%
Furman Int/Allen University Student [2951] $3,489 285%
Quiktrip-First Health [3067] $3,489 285%
Golden Rule Insurance Company [2991] $7,650 626%
Oxford Health Plans [2992] $7,650 626%
Zzumr-Salt Lake City Ut [3169] $7,650 626%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1330 Taylor at Marion St, Columbia, SC 29220
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals