CMS Price Transparency Data

Colonoscopy with biopsy

Facility: De Tar Hospital Navarro

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,229
  • Cash Discount Price: $6,599
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at De Tar Hospital Navarro is $1,229. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,599. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.01x the Medicare baseline. Located in 506 E San Antonio St, Victoria, TX.
Cash / Self-Pay
$6,599

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,229

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: $6,599 (540%)
Insurance Median: $1,229 (101%)
Cash: $6,599 (540% of Medicare)
Ins. Median: $1,229 (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
Veterans Eval Services $398 33%
Medicaid / KanCare $452 - $5,940 37%
Scott & White $452 37%
UnitedHealthcare $452 - $8,955 37%
Blue Cross Blue Shield $461 - $6,567 38%
Multiplan $1,013 - $25,137 83%
Amerigroup $1,067 87%
Tricare $1,142 - $1,202 93%
Humana $1,183 97%
Medicare (plans) $1,183 97%
Department Of Veterans Affairs $1,202 98%
Node Hospice Non Par Agree $1,202 98%
Node Triwest $1,202 98%
Node Va $1,202 98%
Aetna $1,218 - $17,910 100%
American Health Mcr Adv $1,230 101%
Provider Partners Health Plan $1,238 101%
Node Amerigroup Mcr Adv $1,242 102%
Node Procare Mcr Adv $1,242 102%
Superior $1,242 - $3,741 102%
Industrial Rehab $1,382 113%
Node Us Dept Of Labor $1,503 123%
Node Brookshire Brothers $2,104 172%
Node Brookshire Brothers Work Comp Tx $2,236 183%
Work Comp $2,404 197%
Elap $2,645 216%
Dars $7,227 591%
Tx Workforce Commission $7,227 591%
Cigna $7,478 - $13,511 612%
Healthsmart $17,282 - $21,995 1414%
First Health $21,367 1748%
Medcorp Southwest Inc $21,995 1799%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 506 E San Antonio St, Victoria, TX 77901
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals