CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Memorial Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $480
  • Cash Discount Price: $701
  • vs. Medicare Baseline: 0.39x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Memorial Medical Center is $480. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $701. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.39x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$701

Average discount available for prompt cash payment at this facility.

Insurance Median
$480

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: $701 (57%)
Insurance Median: $480 (39%)
Cash: $701 (57% of Medicare)
Ins. Median: $480 (39% 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
Ambetter / Centene $141 - $426 12%
Triwest Va Pccc-All Plans $170 - $212 14%
Amerigroup Mcr Adv-All Other Plans $174 - $216 14%
Care Improvement Plus - All Other Plans $174 - $216 14%
Care Improvement Plus Mcr $174 - $218 14%
Superior Allwell Mcr Adv-All Other Plans $174 - $216 14%
UnitedHealthcare $174 - $1,332 14%
Universal American Mcr-All Other Plans $174 - $216 14%
Universal American Snp $183 - $227 15%
Coventry First Hlth Mcr Adv $216 - $217 18%
Multiplan Mcr Adv $216 - $1,132 18%
Coventry First Hlth Hmo Ppo-All Other Plans $217 - $801 18%
Galaxy Health Network-All Plans $252 - $851 21%
Healthcare Highways-All Plans $287 - $866 23%
Prime Healthcare Services-All Plans $309 - $932 25%
Blue Cross Blue Shield $331 - $1,065 27%
Humana $354 - $1,065 29%
Capstar Health Network-All Plans $360 - $801 29%
Cigna $360 29%
Corvel Work Comp-All Plans $376 - $1,132 31%
Independent Med Sys Ppo-All Plans $376 - $1,132 31%
Multiplan Phcs Ppo-All Other Plans $376 - $1,132 31%
Provider Select Ppo-All Plans $376 - $1,132 31%
Three Rivers Ppo-All Plans $376 - $1,132 31%
Usa Mso - All Plans $376 - $1,132 31%
Amerigroup Chip $442 - $1,332 36%
Amerigroup Star $442 - $1,332 36%
Amerigroup Star Kids $442 - $1,332 36%
Amerigroup Star Plus $442 - $1,332 36%
Comm Health Chip $442 - $1,332 36%
Comm Health Perinatal-All Other Plans $442 - $1,332 36%
Molina Chip/Star-All Plans $442 - $1,332 36%
Scott & White Chip/Star-All Plans $442 - $1,332 36%
Superior Chip/Star $442 - $1,332 36%
Texas Childrens Hp - All Plans $442 - $1,332 36%
Comm Health Mcaid Hmo $464 - $1,398 38%
Comm Health Star $464 - $1,398 38%
Aetna $801 66%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N Virginia St, Port Lavaca, TX 77979
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals