CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Cascade Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,058
Cash Discount Price: $1,808
vs. Medicare Baseline: 0.87x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Cascade Medical Center is $1,058. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,808. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.87x the Medicare baseline. Located in 817 Commercial Street, Leavenworth, WA.

Cash / Self-Pay

$1,808

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,058

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: $1,808 (148%)

Insurance Median: $1,058 (87%)

Cash: $1,808 (148% of Medicare)

Ins. Median: $1,058 (87% 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	$201 - $3,011	16%
Asuris Northwest Health	$201 - $3,011	16%
Blue Cross Blue Shield	$201 - $2,543	16%
Humana	$201 - $1,935	16%
Medicare (plans)	$201 - $1,935	16%
Molina Healthcare Of Washington Mcr Adv	$203 - $1,954	17%
Wellcare Health Plan Inc Mcr Adv	$217 - $2,089	18%
Tricare	$442	36%
First Choice Health Network	$560	46%
Pacificsource Health Plans	$560	46%
Medicaid / KanCare	$628 - $1,787	51%
Community Health Plan Of Wa Mcd Rep	$654 - $1,861	53%
Coordinated Care Of Wa Mcd Rep	$654 - $1,861	53%
Molina Healthcare Of Washington Mcd Rep	$654 - $1,861	53%
Ambetter / Centene	$737 - $2,098	60%
Community Health Plan Of Wa	$764 - $2,175	62%
Cigna	$982 - $2,797	80%
Washington Department Of Labor And Industry	$1,048 - $2,985	86%

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 $1,808.
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 Cascade 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.