CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Metro Nashville General Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $436
Cash Discount Price: $900
vs. Medicare Baseline: 0.36x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Metro Nashville General Hospital is $436. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $900. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.36x the Medicare baseline. Located in 1818 Albion Street, Nashville, TN.

Cash / Self-Pay

$900

Average discount available for prompt cash payment at this facility.

Insurance Median

$436

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: $900 (74%)

Insurance Median: $436 (36%)

Cash: $900 (74% of Medicare)

Ins. Median: $436 (36% 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
UnitedHealthcare	$99 - $1,124	8%
Corizon	$118 - $735	10%
Amerigroup	$158 - $984	13%
Amerivantage	$158 - $984	13%
Aetna	$181 - $1,630	15%
Blue	$181 - $1,124	15%
Cigna	$181 - $1,124	15%
Humana	$181 - $1,124	15%
Medicare (plans)	$181 - $1,124	15%
Upmc	$181 - $1,124	15%
Wellcare	$181 - $1,124	15%
Farm Bureau	$184 - $1,147	15%
Corecivic	$199 - $1,237	16%
Ambetter / Centene	$253 - $1,574	21%
Naphcare	$271 - $1,687	22%
Provider Network Of America	$307 - $1,911	25%
Blue Cross Blue Shield	$419 - $554	34%

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 $900.
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 Metro Nashville General 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.