CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Trios Health

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,321
Cash Discount Price: $1,030
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Trios Health is $1,321. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,030. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.08x the Medicare baseline. Located in 3780 Plaza Way, Kennewick, WA.

Cash / Self-Pay

$1,030

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,321

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: $1,030 (84%)

Insurance Median: $1,321 (108%)

Cash: $1,030 (84% of Medicare)

Ins. Median: $1,321 (108% 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
Community Health Plan Of Washington	$646	53%
Molina Healthcare Of Washington	$646 - $1,321	53%
Coordinated Care Of Washington Inc	$665	54%
Wellpoint Washington, Inc.	$678	55%
Ods Community Health Inc	$981	80%
Aetna	$1,169 - $1,898	96%
Veteran Family Member Program	$1,204	98%
Cigna	$1,227 - $2,201	100%
UnitedHealthcare	$1,258 - $3,577	103%
Summit Health Plan	$1,300	106%
Humana	$1,321	108%
Asuris Northwest Health	$1,510	124%
Government Employees Health Association	$1,842	151%
Meritain Health	$2,105	172%
Bridgespan Health Company	$2,987	244%
Blue Cross Blue Shield	$3,102	254%
Lifewise Health Plan Of Wa	$3,102	254%

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 $1,030.
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 Trios Health 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.