CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Lake Granbury Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,346
  • Cash Discount Price: $4,632
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Lake Granbury Medical Center is $1,346. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,632. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.10x the Medicare baseline. Located in 1310 Paluxy Rd, Granbury, TX.
Cash / Self-Pay
$4,632

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,346

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: $4,632 (379%)
Insurance Median: $1,346 (110%)
Cash: $4,632 (379% of Medicare)
Ins. Median: $1,346 (110% 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%
Aetna $452 - $17,677 37%
Medicaid / KanCare $452 - $1,707 37%
UnitedHealthcare $452 - $10,938 37%
Amerigroup $474 39%
Healthspring $474 39%
Superior $519 - $3,591 42%
Tricare $1,142 93%
Node Champva $1,202 98%
Cigna $1,290 - $10,138 106%
Humana $1,290 106%
Medicare (plans) $1,290 106%
Hospice Non Par $1,311 107%
Node Va $1,311 107%
Triwest $1,311 107%
Blue Cross Blue Shield $1,316 - $6,484 108%
Node Care N Care $1,316 108%
American Health $1,341 110%
Provider Partners Health Plan $1,350 110%
Node Amerigroup Mcr Adv $1,354 111%
Self Pay $1,544 126%
Node Us Dept Of Labor $1,638 134%
Node Brookshire Brothers $2,294 188%
93% Payors Work Comp Tx $2,438 199%
Node Brookshire Brothers Work Comp Tx $2,438 199%
Work Comp $2,621 214%
Healthsmart $14,152 - $18,012 1158%
Multiplan $19,298 - $22,643 1578%
Santa Fe Hospital Association $20,585 1684%
Galaxy Health $24,444 1999%
Medcorp Southwest $24,444 1999%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1310 Paluxy Rd, Granbury, TX 76048
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals