CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Yoakum County Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $617
Cash Discount Price: $1,441
vs. Medicare Baseline: 0.50x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Yoakum County Hospital is $617. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,441. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.50x the Medicare baseline. Located in 412 Mustang Avenue, Denver City, TX.

Cash / Self-Pay

$1,441

Average discount available for prompt cash payment at this facility.

Insurance Median

$617

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: $1,441 (118%)

Insurance Median: $617 (50%)

Cash: $1,441 (118% of Medicare)

Ins. Median: $617 (50% 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
Healthsmart	$139 - $1,913	11%
Aetna	$181 - $1,925	15%
Humana	$195 - $1,472	16%
UnitedHealthcare	$195 - $1,811	16%
90 Degree Benefits	$209 - $309	17%
Cigna	$401 - $1,472	33%
Insurance Services Of Lubbock	$401 - $2,400	33%
Firstcare	$407 - $1,585	33%
Multiplan	$407 - $1,981	33%
Dars	$432 - $1,585	35%
Phcs	$525 - $1,925	43%
Capstar	$556 - $2,038	45%
Provider Network	$602 - $2,208	49%
Blue Cross Blue Shield	$617 - $2,264	50%

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 $1,441.
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 Yoakum County Hospital 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.