CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Camc Greenbrier Valley Medical Center, Inc

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $269
Cash Discount Price: $3,269
vs. Medicare Baseline: 0.22x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Camc Greenbrier Valley Medical Center, Inc is $269. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,269. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.22x the Medicare baseline. Located in 1320 Maplewood Avenue, Ronceverte, WV.

Cash / Self-Pay

$3,269

Average discount available for prompt cash payment at this facility.

Insurance Median

$269

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: $3,269 (267%)

Insurance Median: $269 (22%)

Cash: $3,269 (267% of Medicare)

Ins. Median: $269 (22% 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	$135 - $5,739	11%
Blue Cross Blue Shield	$135 - $5,417	11%
Caresource	$135 - $4,685	11%
Sentra Health	$135 - $2,050	11%
The Health Plan	$135 - $5,270	11%
Unicare	$135 - $156	11%
Humana	$143 - $5,270	12%
Multiplan	$143 - $5,095	12%
UnitedHealthcare	$143 - $4,685	12%
Clear Spring Health	$147 - $1,214	12%
Ally Align	$150 - $1,238	12%
Integrated Medical Solutions	$200 - $2,240	16%
Naphcare	$286 - $2,358	23%
Greenbrier Resort	$477 - $3,514	39%
Healthsmart	$545 - $3,514	45%
Fedmed	$613 - $5,270	50%

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 $3,269.
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 Camc Greenbrier Valley Medical Center, Inc 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.