Colonoscopy with biopsy
Facility: The Medical Center of Southeast Texas
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $1,148
- Cash Discount Price: $5,211
- vs. Medicare Baseline: 0.94x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Amerigroup | $413 - $1,027 | 34% |
| Harbor Hospice | $413 | 34% |
| Medicaid / KanCare | $429 - $795 | 35% |
| Texas Childrens Health Plan | $429 - $451 | 35% |
| League Medical Concepts | $436 - $1,130 | 36% |
| Community Health Choice Uhrip | $451 | 37% |
| Molina Healthcare | $451 - $1,409 | 37% |
| UnitedHealthcare | $451 - $3,050 | 37% |
| Beacon Health | $494 | 40% |
| Superior Healthplan | $495 - $1,027 | 40% |
| Employer Direct Healthcare | $503 - $1,044 | 41% |
| Texas Medical Management Partners | $503 - $1,044 | 41% |
| Blue Cross Blue Shield | $773 - $2,152 | 63% |
| Self Pay Emergent | $782 | 64% |
| Medsolutions | $924 | 76% |
| Humana | $991 - $3,006 | 81% |
| Healthspring | $1,027 | 84% |
| Medicare (plans) | $1,027 | 84% |
| Provider Partners Health Plan | $1,027 | 84% |
| Selectcare | $1,027 | 84% |
| Tihp (Texas Independence Health Plan) | $1,027 | 84% |
| Caresact | $1,044 | 85% |
| Hospice | $1,044 | 85% |
| Rice Land Hospice | $1,044 | 85% |
| Tricare | $1,044 | 85% |
| Triwest | $1,044 | 85% |
| Cccn Pro Advantage | $1,078 | 88% |
| Wellcare Of Texas | $1,078 | 88% |
| Wellpath | $1,148 | 94% |
| Community Health Choice | $1,252 | 102% |
| Corporate Remedies | $1,541 | 126% |
| Cigna | $1,845 - $3,648 | 151% |
| Elap Services | $2,023 | 165% |
| Texas Workers Compensation | $2,087 | 171% |
| Iasis Employees | $2,149 | 176% |
| Aetna | $2,578 - $3,440 | 211% |
| Dept Of Assistive And Rehabilitative Services | $2,606 | 213% |
| Magellan Behavioral Health | $3,127 | 256% |
| First Health | $3,440 | 281% |
| Galaxy Health Network | $3,648 | 298% |
| Private Healthcare Systems | $3,648 | 298% |
| Texas Municipal League | $3,648 | 298% |
| Healthsmart | $3,909 | 320% |
| Multiplan | $4,169 | 341% |
| Commercial Non-Contracted | $5,211 | 426% |
| Heart To Heart Hospice | $5,211 | 426% |
| Lifesynch | $5,211 | 426% |
| Mhnet | $5,211 | 426% |
| Self Pay - Mcd Pending 100 Percent | $5,211 | 426% |
| Single Case Agreement | $5,211 | 426% |
| United Behavioral Health | $5,211 | 426% |