CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Upland Hills Health

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,347
Cash Discount Price: $1,649
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Upland Hills Health is $1,347. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,649. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.10x the Medicare baseline. Located in 800 Compassion Way, Dodgeville, WI.

Cash / Self-Pay

$1,649

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,347

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: $1,649 (135%)

Insurance Median: $1,347 (110%)

Cash: $1,649 (135% of Medicare)

Ins. Median: $1,347 (110% 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
Humana	$178 - $3,479	15%
Dean Health Plan	$343 - $3,346	28%
UnitedHealthcare	$403 - $773	33%
Alliance	$817 - $2,208	67%
Blue Cross Blue Shield	$1,082 - $3,170	89%
Icare	$1,082	89%
Medical Associates	$1,082 - $2,900	89%
Mhs	$1,082 - $1,347	89%
Security Health Plan	$1,082	89%
Ghc Of Eau Claire	$1,347	110%
Ghc Of Sc Wi	$1,347 - $2,629	110%
Wps	$2,358 - $2,432	193%
Quartz	$2,668	218%
Cigna	$2,884 - $3,224	236%
Multiplan	$3,402	278%

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 $1,649.
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 Upland Hills Health 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.