CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Wellmont Bristol Regional Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,198
  • Cash Discount Price: $484
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Wellmont Bristol Regional Medical Center is $1,198. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $484. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.98x the Medicare baseline. Located in One Medical Park Blvd, Bristol, TN.
Cash / Self-Pay
$484

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,198

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: $484 (40%)
Insurance Median: $1,198 (98%)
Cash: $484 (40% of Medicare)
Ins. Median: $1,198 (98% 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
Blue Cross Blue Shield $775 - $3,227 63%
Sentara Health $833 - $1,135 68%
UnitedHealthcare $1,008 - $1,861 82%
Aetna $1,135 - $1,378 93%
Humana $1,135 93%
Managed Medicaire $1,135 93%
Medicare (plans) $1,135 93%
United Mine Workers Of America $1,135 93%
Amerigroup $1,181 97%
Cigna $1,192 - $2,588 98%
Devoted Health Plan $1,192 98%
Molina Healthcare $1,192 - $1,313 98%
Mountain Empire Pace $1,192 98%
Nhc Advantage $1,192 98%
Wellcare $1,203 - $3,227 98%
Optima Health $1,289 105%
Medcost $1,536 126%
Ambetter / Centene $2,475 202%
First Health Coventry $2,485 203%
Seven Corners, Inc. $2,724 223%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Medical Park Blvd, Bristol, TN 37620
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals