CMS Price Transparency Data

Colonoscopy with biopsy

Facility: The Hospital at Westlake Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,056
Cash Discount Price: $2,279
vs. Medicare Baseline: 0.86x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at The Hospital at Westlake Medical Center is $1,056. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,279. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.86x the Medicare baseline. Located in 5656 Bee Caves Road, Suite M-302, Austin, TX.

Cash / Self-Pay

$2,279

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,056

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: $2,279 (186%)

Insurance Median: $1,056 (86%)

Cash: $2,279 (186% of Medicare)

Ins. Median: $1,056 (86% 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
Blue Cross Blue Shield	$663 - $1,056	54%
Tx_Free_Market	$816	67%
Medicaid / KanCare	$1,025	84%
Aetna	$1,056 - $2,115	86%
Ambetter / Centene	$1,056	86%
Edhp	$1,056	86%
Humana	$1,056 - $4,207	86%
Mcr_United	$1,056	86%
Medicare (plans)	$1,056	86%
Sendero	$1,056	86%
Tricare	$1,056	86%
Triwest	$1,056	86%
Wellcare	$1,056	86%
Cigna	$1,415	116%
90_Degree_Benefits	$1,583	129%
Superior_Mcd	$2,913	238%
Scott_And_White	$3,560	291%
Multiplan	$4,207	344%
Beech_Street	$4,531	371%

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 $2,279.
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 The Hospital at Westlake 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.