CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Marshfield Medical Center - Weston

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,314
Cash Discount Price: $1,314
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Marshfield Medical Center - Weston is $1,314. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,314. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.07x the Medicare baseline. Located in 3400 Ministry Parkway, Weston, WI.

Cash / Self-Pay

$1,314

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,314

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: $1,314 (107%)

Insurance Median: $1,314 (107%)

Cash: $1,314 (107% of Medicare)

Ins. Median: $1,314 (107% 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
Family Health Center (Fhc)	$692	57%
Amish/Mennonite	$761	62%
Sanford Health Plan	$761	62%
The Alliance	$1,065 - $2,971	87%
Security Health Plan (Shp)	$1,120 - $2,857	92%
UnitedHealthcare	$1,120 - $1,142	92%
Veteran'S Administration (Va Ccn)	$1,120	92%
Group Health Cooperative Of Eau Claire	$1,134 - $1,245	93%
Blue Cross Blue Shield	$1,153 - $4,686	94%
Besse Forest Products	$1,176	96%
Molina Healthcare Of Wi	$1,176	96%
Rice Lake School District	$1,176	96%
Wps Health Insurance	$1,224 - $1,335	100%
Medica Of Wi	$1,289 - $1,317	105%
Cigna	$1,300	106%
Healtheos By Multiplan Inc.	$1,300 - $1,314	106%
Corvel	$1,314	107%
First Health	$1,314	107%
Health Partners	$1,314	107%
Three Rivers Provider Network (Trpn)	$1,314	107%
Trilogy	$1,321 - $1,328	108%
Coventry	$1,328	109%
Health Smart	$1,328	109%
Rising Medical Work Comp	$1,342	110%

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 $1,314.
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 Marshfield Medical Center - Weston 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.