CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Bellin Memorial Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $2,983
Cash Discount Price: $2,924
vs. Medicare Baseline: 2.44x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Bellin Memorial Hospital is $2,983. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,924. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 2.44x the Medicare baseline. Located in 744 S Webster Ave, Green Bay, WI.

Cash / Self-Pay

$2,924

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,983

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: $2,924 (239%)

Insurance Median: $2,983 (244%)

Cash: $2,924 (239% of Medicare)

Ins. Median: $2,983 (244% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 244% of the Medicare baseline (a markup of 144%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$685 - $3,384	56%
Aetna	$1,079 - $1,160	88%
Community Care	$1,079 - $2,528	88%
Humana	$1,079 - $2,528	88%
My Choice	$1,079 - $1,160	88%
Network Health	$1,120 - $4,830	92%
UnitedHealthcare	$1,124 - $3,144	92%
Common Ground	$2,699	221%
Chorus Community Health Plan	$2,892	237%
Aspirus Arise	$3,104 - $3,243	254%
Cigna	$3,171 - $3,207	259%
Wps Insurance	$3,282 - $3,823	268%
Hps/Paymedix	$3,329 - $3,598	272%
Trilogy	$3,418	280%
Healthsmart	$3,598	294%
Ihs(Claimsbridge)	$3,598	294%
Medical College Of Wi	$3,598	294%
Multiplan	$3,598	294%
Allied National	$3,823	313%
First Health	$3,823	313%
Galaxy Health	$3,823	313%
Three Rivers Provider Network	$4,048	331%

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 $2,924.
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 Bellin Memorial 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.