CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Smyth County Community Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,270
  • Cash Discount Price: $484
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Smyth County Community Hospital is $1,270. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $484. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.04x the Medicare baseline. Located in 245 Medical Park Drive, Marion, VA.
Cash / Self-Pay
$484

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,270

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: $484 (40%)
Insurance Median: $1,270 (104%)
Cash: $484 (40% of Medicare)
Ins. Median: $1,270 (104% 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
Sentara Health $898 - $1,168 73%
Blue Cross Blue Shield $948 - $3,227 78%
UnitedHealthcare $1,107 - $2,397 91%
Medcost $1,129 92%
Aetna $1,168 - $2,743 96%
Amerigroup $1,168 - $3,227 96%
Humana $1,168 96%
Managed Medicaire $1,168 96%
Medicare (plans) $1,168 96%
United Mine Workers Of America $1,168 96%
Molina Healthcare $1,214 - $1,321 99%
Cigna $1,226 - $1,956 100%
Devoted Health Plan $1,226 100%
Nhc Advantage $1,226 100%
Optima Health $1,270 104%
Ambetter / Centene $2,545 208%
First Health Coventry $3,227 264%
Seven Corners, Inc. $3,227 264%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 245 Medical Park Drive, Marion, VA 24354
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals