Colonoscopy with biopsy
Facility: Portneuf Medical Center
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $5,391
- Cash Discount Price: $3,814
- vs. Medicare Baseline: 4.41x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 441% of the Medicare baseline (a markup of 341%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $1,081 - $5,721 | 88% |
| Department of Corrections [1340] | $1,081 | 88% |
| Medicaid / KanCare | $1,081 | 88% |
| Bannock County Jail [6050] | $1,081 | 88% |
| Pending County Rca [3910] | $1,087 | 89% |
| Healthscope Benefits [2290] | $1,310 | 107% |
| Aetna | $1,310 - $5,391 | 107% |
| Employee Benefit Management Services [2445] | $2,606 - $3,814 | 213% |
| Lucent Health [6000] | $2,606 | 213% |
| Black Lung [6055] | $2,606 | 213% |
| Healthcare Highways [2210] | $2,606 - $6,039 | 213% |
| Pending Ssi [1616] | $2,606 | 213% |
| Moda Health [6100] | $2,606 | 213% |
| Web Tpa [2115] | $2,606 | 213% |
| Oncology Patient Assistance Programs [2295] | $2,606 | 213% |
| Medishare Christian Care [1645] | $3,814 | 312% |
| Liberty Health Share Lhs/Medcost Solutions LLC [2400] | $3,814 | 312% |
| First Health [1375] | $5,245 | 429% |
| Mailhandlers [1595] | $5,391 | 441% |
| Selecthealth [3740] | $5,391 - $5,721 | 441% |
| Cigna | $5,613 | 459% |
| Humana | $5,721 | 468% |
| Geha [1415] | $5,721 | 468% |
| Healthnet [1495] | $6,039 | 494% |
| Pan American Life Insurance Co [1770] | $6,039 | 494% |
| National Association of Letter Carriers [1695] | $6,039 | 494% |
| Multiplan [1680] | $6,039 | 494% |
| UT Id Teamsters [3760] | $6,039 | 494% |
| Mayo Clinic Health Solutions [2280] | $6,039 | 494% |
| Meritain Health [1655] | $6,039 | 494% |
| PHCS [1780] | $6,039 | 494% |
| Mutual of Omaha [1685] | $6,039 | 494% |
| Hometown Health [2155] | $6,039 | 494% |
| Trustmark [2030] | $6,039 | 494% |
| New Era Life Insurance Company [1705] | $6,039 | 494% |
| Planned Administrators Inc [2360] | $6,039 | 494% |
| Healthfirst [2395] | $6,039 | 494% |
| Administrative Concepts [1005] | $6,039 | 494% |
| Pba [1775] | $6,039 | 494% |