CMS Price Transparency Data

Colonoscopy with biopsy

Facility: University of Texas M. D. Anderson Cancer Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $2,309
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.89x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at University of Texas M. D. Anderson Cancer Center is $2,309. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.89x the Medicare baseline. Located in 1515 Holcombe Blvd, Houston, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,309

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%)

Insurance Median: $2,309 (189%)

Ins. Median: $2,309 (189% 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
Texaschildrens	$146 - $1,451	12%
Tricare	$171 - $2,474	14%
Vacare	$171 - $1,934	14%
Medicare (plans)	$241 - $1,451	20%
UnitedHealthcare	$285 - $2,474	23%
Blue Cross Blue Shield	$349 - $2,375	29%
Aetna	$439 - $2,474	36%
Cigna	$485 - $2,474	40%
Humana	$1,215 - $2,539	99%
Ontarioministriesofhealth	$1,498 - $2,441	123%
Beijingst.Lucia	$1,519 - $2,474	124%
Embassyofqatar	$1,519 - $2,474	124%
Memorialhermannhealth	$1,519 - $2,474	124%
Emergingtherapysolutions_Cancercare	$1,620 - $2,638	133%
Interlink_Cancercare	$1,620 - $2,638	133%
Saudiarmedforces	$1,620 - $2,638	133%
Uae_Medical	$1,620 - $2,638	133%
Uaepoliceattache	$1,620 - $2,638	133%
Healthsmart	$1,721 - $2,803	141%
Vantage	$1,721 - $2,803	141%
Multiplan	$1,752 - $2,836	143%
Phcs	$1,752 - $2,836	143%
Emergingtherapysolutions	$2,474 - $2,638	202%
Interlink	$2,474 - $2,803	202%

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 $X.
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 University of Texas M. D. Anderson Cancer Center 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.