CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Tennova Healthcare - Clarksville

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,486
  • Cash Discount Price: $2,393
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Tennova Healthcare - Clarksville is $1,486. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,393. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.22x the Medicare baseline. Located in 651 Dunlop Lane, Clarksville, TN.
Cash / Self-Pay
$2,393

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,486

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: $2,393 (196%)
Insurance Median: $1,486 (122%)
Cash: $2,393 (196% of Medicare)
Ins. Median: $1,486 (122% 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
Veterans Eval Services $378 31%
Amerigroup $801 66%
Blue Cross Blue Shield $862 - $2,522 71%
Medicaid / KanCare $886 - $3,084 72%
UnitedHealthcare $886 - $2,179 72%
Tricare $1,132 93%
Cigna $1,155 - $2,568 94%
Humana $1,173 - $2,714 96%
Medicare (plans) $1,173 96%
Node Windsor Mcr Dual $1,173 96%
Node Devoted Health Mcr Adv $1,191 97%
Node Bluecare Plus Tn Mcr Adv $1,192 98%
Node Champva $1,192 98%
Node Hospice Non Par Agree $1,192 98%
Node Va $1,192 98%
Node Wellcare Mcr Adv $1,192 98%
American Health $1,196 98%
Node Ascension Complete Mcr Adv $1,196 98%
Node Farm Bureau Mcr Adv $1,196 98%
Node Healthspring Mcr Adv $1,196 98%
Aetna $1,208 - $2,788 99%
Node Amerigroup Mcr Adv $1,232 101%
Node Nhc Mcr Adv $1,290 106%
Node Us Dept Of Labor $1,490 122%
Corvel $1,680 137%
Rockport Work Comp Tn $1,680 137%
Novanet Work Comp Tn $1,733 142%
Prime Health Work Comp Tn $1,733 142%
Tn Work Comp $1,769 145%
Ambetter / Centene $2,205 180%
Ky Work Comp $2,341 191%
Node Valenz Access $2,384 195%
Multiplan $2,392 196%
Self Pay $2,393 196%
Naphcare $2,682 219%
Wellcare $3,084 252%
Oscar $7,193 588%
Center Care $8,019 656%
Correct Care Solutions $11,103 908%
First Health $11,103 908%
Phcs $11,720 959%
Prime Health Services $11,720 959%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 Dunlop Lane, Clarksville, TN 37040
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals