CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Dickenson Community Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,028
Cash Discount Price: $475
vs. Medicare Baseline: 0.84x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Dickenson Community Hospital is $1,028. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $475. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.84x the Medicare baseline. Located in 312 Hospital Drive, Clintwood, VA.

Cash / Self-Pay

$475

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,028

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: $475 (39%)

Insurance Median: $1,028 (84%)

Cash: $475 (39% of Medicare)

Ins. Median: $1,028 (84% 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
Aetna	$620 - $1,888	51%
Amerigroup	$620	51%
Blue Cross Blue Shield	$620 - $2,065	51%
Managed Medicaire	$620	51%
Medicare (plans)	$620	51%
Sentara Health	$620 - $762	51%
United Mine Workers Of America	$620	51%
UnitedHealthcare	$620 - $2,065	51%
Humana	$629	51%
Molina Healthcare	$644 - $1,888	53%
Cigna	$650 - $1,956	53%
Devoted Health Plan	$650	53%
Nhc Advantage	$650	53%
Medcost	$723	59%
Ambetter / Centene	$764	62%
Optima Health	$1,815	148%
Seven Corners, Inc.	$2,065	169%

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 $475.
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 Dickenson Community 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.