CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Snoqualmie Valley Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $902
Cash Discount Price: $1,359
vs. Medicare Baseline: 0.74x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Snoqualmie Valley Hospital is $902. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,359. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.74x the Medicare baseline. Located in 9801 Frontier Ave Se, Snoqualmie, WA.

Cash / Self-Pay

$1,359

Average discount available for prompt cash payment at this facility.

Insurance Median

$902

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: $1,359 (111%)

Insurance Median: $902 (74%)

Cash: $1,359 (111% of Medicare)

Ins. Median: $902 (74% 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 Wa Mcd Rep	$254 - $1,599	21%
Medicaid / KanCare	$254 - $1,599	21%
UnitedHealthcare	$254 - $3,151	21%
Amerigroup Wellpoint	$269 - $1,695	22%
Washington Coordinated Care	$274 - $1,727	22%
Molina Healthcare Of Washington Mcd Rep	$279 - $1,727	23%
Aetna	$532 - $1,443	44%
Humana	$537 - $1,458	44%
Blue Shield Of Wa Regence Mcr Adv	$551 - $1,458	45%
Community Health Plan Of Wa	$551 - $1,473	45%
Medicare (plans)	$551 - $1,443	45%
Molina Healthcare Of Washington Mcr Adv	$551 - $1,443	45%
First Choice Health Network	$560 - $2,397	46%
Molina Healthcare Of Washington	$563 - $1,473	46%
Blue Cross Blue Shield	$594 - $2,055	49%
Blue Shield Of Wa Regence	$712 - $2,055	58%
Kaiser Foundation Health Plan Of The Northwest	$795 - $2,156	65%
Cigna	$1,010 - $2,740	83%

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 $1,359.
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 Snoqualmie Valley 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.