CMS Price Transparency Data

Colonoscopy with biopsy

Facility: UT of Texas Southwestern University Hospital - William P. Clements Jr.

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,238
  • Cash Discount Price: $2,969
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at UT of Texas Southwestern University Hospital - William P. Clements Jr. is $1,238. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,969. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.01x the Medicare baseline. Located in 6201 Harry Hines Blvd, Dallas, TX.
Cash / Self-Pay
$2,969

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,238

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: $2,969 (243%)
Insurance Median: $1,238 (101%)
Cash: $2,969 (243% of Medicare)
Ins. Median: $1,238 (101% 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
Molina $158 - $1,238 13%
Parkland $158 - $429 13%
UnitedHealthcare $158 - $4,287 13%
Wellpoint $158 - $1,238 13%
Aetna $182 - $2,874 15%
Superior $185 - $1,238 15%
Procare $193 - $1,179 16%
Ambetter / Centene $197 16%
Blue Cross Blue Shield $202 - $4,437 17%
Humana $202 - $1,226 17%
Healthfirst $378 - $3,337 31%
Quiktrip $433 - $3,741 35%
United Options Nexus $576 - $6,261 47%
Cigna $818 - $4,373 67%
Coventry $967 - $4,151 79%
Maestro Health/Fort Worth Firefighters $976 - $3,174 80%
Rockwall County $1,161 - $4,157 95%
Galaxy Health Network $1,493 - $5,225 122%
Multiplan $1,493 - $5,166 122%
Phcs $1,528 - $4,816 125%
Healthsmart $2,161 - $4,929 177%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6201 Harry Hines Blvd, Dallas, TX 75390
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals