CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Olympic Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,209
Cash Discount Price: $1,730
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Olympic Medical Center is $1,209. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,730. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.99x the Medicare baseline. Located in 939 Caroline St, Port Angeles, WA.

Cash / Self-Pay

$1,730

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,209

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: $1,730 (142%)

Insurance Median: $1,209 (99%)

Cash: $1,730 (142% of Medicare)

Ins. Median: $1,209 (99% 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
Regence Uniform	$321 - $2,096	26%
Community Health Plan Of Washington	$460 - $3,000	38%
Ambetter / Centene	$518 - $3,563	42%
Cigna	$560 - $3,653	46%
Aetna	$575 - $3,750	47%
First Choice Network	$575 - $3,750	47%
Gmr/Caldera Care	$575 - $3,750	47%
Hma	$575 - $3,750	47%
Lifewise	$575 - $3,750	47%
Premera	$575 - $3,750	47%
Regence	$575 - $3,750	47%
UnitedHealthcare	$575 - $3,750	47%
Wellcare	$979	80%
Coordinated Care	$1,181	97%
Molina	$1,181 - $1,518	97%
Wellpoint (Formerly Amerigroup)	$1,237	101%

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 $1,730.
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 Olympic 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.