CMS Price Transparency Data
Colonoscopy with biopsy
Facility: Clovis Community Medical Center
Billing Code: 45380 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 45380
- Insurance Median: $509
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.42x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Clovis Community Medical Center is $509. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.42x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$509
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%)
Insurance Median: $509 (42%)
Ins. Median: $509 (42% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Ccs Madera/Sacramento | $330 | 27% |
| Ccs Mariposa | $330 | 27% |
| Ccs Fresno | $330 | 27% |
| Medi-Cal Molina | $330 | 27% |
| Ccs Kings | $330 | 27% |
| Chdp | $330 | 27% |
| San Francisco Health Plan Medi-Cal | $330 | 27% |
| Santa Clara Family Health Plan - Premier Health | $330 | 27% |
| Medi-Cal Community Health Group | $330 | 27% |
| Medi-Cal Blue Shield Promise Health | $330 | 27% |
| Generic Care Out of County | $330 | 27% |
| Medi-Cal California Health & Wellness Plan | $330 | 27% |
| Ccs Merced | $330 | 27% |
| Medi-Cal Inland Empire Health | $330 | 27% |
| Medi-Cal Health Plan of San Mateo | $330 | 27% |
| Medi-Cal Cencal Health | $330 | 27% |
| Cal Caloptima | $330 | 27% |
| Medi-Cal Alameda Alliance for Health | $330 | 27% |
| Medi-Cal Partnership Health Plan of Ca | $330 | 27% |
| Fresno County Funded Specialty Care | $330 | 27% |
| Ccs Stanislaus | $330 | 27% |
| Ccs Kern | $330 | 27% |
| Ccs Tulare | $330 | 27% |
| Generic Ccs Other Counties | $330 | 27% |
| Blue Cross Blue Shield | $330 - $3,630 | 27% |
| Blue Shield | $330 - $4,696 | 27% |
| Medi-Cal La Care Health | $330 | 27% |
| Santa Clara Family Health Plan - Valley Health | $330 | 27% |
| Gold Coast Medi-Cal | $330 | 27% |
| Medi-Cal Kern Family Health | $330 | 27% |
| Medi-Cal Contra Costa Health Plan | $330 | 27% |
| Genetically Handicapped Person | $330 | 27% |
| Sequoia Pace | $495 | 40% |
| Health Plan of San Joaquin | $495 | 40% |
| Blue Shield 65 Plus HMO Ehs | $509 - $1,539 | 42% |
| Sequoia Pace - Peak Tpa | $509 - $1,539 | 42% |
| Railroad Part A | $509 - $1,539 | 42% |
| Cares Act Provider Relief Fund | $509 - $1,539 | 42% |
| Generic | $509 - $1,539 | 42% |
| Care1St HMO - Ehs | $509 - $1,539 | 42% |
| Humana | $509 - $1,539 | 42% |
| Well Path (Cfmg) | $509 | 42% |
| Railroad Part A & B | $509 - $1,539 | 42% |
| Us Marshal | $509 - $1,539 | 42% |
| Medi-Cal Innovative Integrated Health | $509 - $1,539 | 42% |
| Blue Shield Saint Agnes | $509 - $1,539 | 42% |
| Gemcare HMO | $509 - $1,539 | 42% |
| Sante-Sub Cap Ma Brand New Day | $509 - $1,539 | 42% |
| Scan Health Plan | $509 - $1,539 | 42% |
| Todays Pyramid | $509 - $1,539 | 42% |
| Blue Shield 65 Plus HMO First Choice | $509 - $1,539 | 42% |
| Bscphp HMO - First Choice | $509 - $1,539 | 42% |
| Blue Shield Sante | $509 - $1,539 | 42% |
| Blue Shield Promise - Imperial | $509 - $1,539 | 42% |
| Healthnet HMO - Cvmp/Medpro | $509 - $1,539 | 42% |
| Hartford Life Supplement | $509 - $1,539 | 42% |
| Sante Sub Cap Healthnet Seniority | $509 - $1,539 | 42% |
| Healthnet HMO - Sante | $509 - $1,539 | 42% |
| Sante-Healthnet Seniority | $509 - $1,539 | 42% |
| Healthnet HMO - Dhmso | $509 - $1,539 | 42% |
| Generic Victims of Crime | $509 - $1,539 | 42% |
| Healthnet Sante Dual Risk | $509 - $1,539 | 42% |
| Healthnet HMO - La Salle | $509 - $1,539 | 42% |
| Healthnet Sante | $509 - $1,539 | 42% |
| Generic Bscphp | $509 - $1,539 | 42% |
| Victims of Crime | $509 - $1,539 | 42% |
| Meritage Blue Shield 65 Plus | $509 - $1,539 | 42% |
| Blue Shield Hmo-Cvmp/Medpro | $509 - $1,539 | 42% |
| Sante | $509 - $1,539 | 42% |
| Meritage Brand New Day | $509 - $1,539 | 42% |
| Aetna | $509 - $4,494 | 42% |
| Railroad Part B | $509 - $1,539 | 42% |
| Cigna | $509 - $5,494 | 42% |
| Wellcare | $509 - $1,539 | 42% |
| Bscphp - Dhmso | $509 - $1,539 | 42% |
| Healthnet Sante - Sub Cap Dual Risk | $509 - $1,539 | 42% |
| Meritage Healthnet HMO | $509 - $1,539 | 42% |
| Sante-Blue Shield/Sante | $509 - $1,539 | 42% |
| Medicare (plans) | $509 - $1,539 | 42% |
| UnitedHealthcare | $509 - $3,982 | 42% |
| Sante Sub Cap-Blue Shield/Sante | $509 - $1,539 | 42% |
| Bscphp - First Choice | $509 - $1,539 | 42% |
| Brand New Day | $509 - $1,539 | 42% |
| Advantek Table Mountain Rancheria Tribal Member | $509 - $1,539 | 42% |
| Adventist -McL Calviva Sub Cap | $545 | 45% |
| Innovative Integrated Health Community Plans HMO | $560 - $1,693 | 46% |
| Alignment Health Plan | $560 - $1,693 | 46% |
| Champion Health Plan of California Ma | $560 - $1,693 | 46% |
| Imperial Health Plan HMO | $585 - $1,770 | 48% |
| Healthnet | $636 | 52% |
| Correctcare Integrated Health | $662 - $2,001 | 54% |
| Coalinga State Hospital | $1,018 - $3,078 | 83% |
| Naphcare Inc-Mendota | $1,094 - $3,309 | 89% |
| Kaiser | $1,223 | 100% |
| Generic Multiplan | $8,490 | 694% |
| PHCS | $8,490 | 694% |