CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Arbor Health Morton Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $254
Cash Discount Price: $727
vs. Medicare Baseline: 0.21x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Arbor Health Morton Hospital is $254. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $727. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.21x the Medicare baseline. Located in 521 Adams Street, Morton, WA.

Cash / Self-Pay

$727

Average discount available for prompt cash payment at this facility.

Insurance Median

$254

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: $727 (59%)

Insurance Median: $254 (21%)

Cash: $727 (59% of Medicare)

Ins. Median: $254 (21% 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	$178 - $657	15%
Amerigroup Mcr Adv	$178	15%
Comm Health Mcr Adv	$178	15%
Healthnet Mcr Adv - All Plans	$178	15%
Humana	$178	15%
Mcr Railroad Mcr Adv - All Plans	$178	15%
Medicare (plans)	$178	15%
Premera Hmo Mcr Adv	$178	15%
Rural Health Mcare - All Plans	$178	15%
UnitedHealthcare	$178 - $938	15%
Regence Blue Shield Mcr Adv	$180	15%
Molina Mcr Adv	$187	15%
Wellcare Mcr Adv - All Plans	$187	15%
Amerigroup-All Other Plans	$254	21%
Comm Health Healthy Options	$254	21%
Kaiser Mcaid	$254	21%
Molina Mcaid	$254	21%
First Choice-All Plans	$275	22%
Kaiser Comm-All Other Plans	$278	23%
Comm Health Basic Sub - All Other Plans	$305	25%
Comm Health Pebb	$457	37%
Molina Marketplace-All Other Plans	$703	58%
Regence Blue Shield Ump-All Other Plans	$820	67%
Premera First-All Other Plans	$1,055	86%
Cigna	$1,090	89%

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 $727.
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 Arbor Health Morton 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.