CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Comanche County Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,041
Cash Discount Price: $1,390
vs. Medicare Baseline: 0.85x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Comanche County Medical Center is $1,041. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,390. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.85x the Medicare baseline. Located in 10201 Hwy 16, Comanche, TX.

Cash / Self-Pay

$1,390

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,041

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: $1,390 (114%)

Insurance Median: $1,041 (85%)

Cash: $1,390 (114% of Medicare)

Ins. Median: $1,041 (85% 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
Choicecare Comm - All Other Plans	$174 - $1,389	14%
Choicecare Mcr Adv	$174 - $1,389	14%
Humana	$174 - $2,628	14%
Molina Mcr Adv - All Other Plans	$174 - $1,389	14%
Pphp Mcr Adv - All Plans	$174 - $1,389	14%
Superior Epo/Hmo - All Plans	$174 - $1,389	14%
Swhp Comm - All Other Plans	$174 - $3,004	14%
Swhp Mcr Adv	$174 - $1,389	14%
Wellmed Mcr Adv - All Plans	$174 - $1,389	14%
Aetna	$194 - $2,366	16%
First Care Hmo - All Other Plans	$194 - $3,192	16%
First Care Hmo Self Funded	$194 - $3,192	16%
Occunet - All Plans	$226 - $2,816	18%
Alliance Wc - All Plans	$261 - $2,084	21%
Cigna	$340 - $2,441	28%
Molina Mcaid	$523 - $2,366	43%
Swhp Mcaid	$523 - $2,366	43%
Blue Cross Blue Shield	$654 - $2,816	53%
Mpi - All Plans	$3,380	276%

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 $1,390.
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 Comanche County Medical Center 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.