CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Highlands Medical Center

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,150

about 0.9× the $1,223 Medicare rate · typically $974–$1,150

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,144

About the fair price

about $6 under the fair price · 0.9× Medicare

Medicare pays $1,223 Fair price $1,150 This hospital $1,144 Cash price $2,439 Hospital's list price $3,485

How we calculate the fair BaseRate →

How this hospital compares to other AL hospitals

Highest price of the 9 AL hospitals we have prices for — worth calling around.

Cheapest $371 Priciest $1,144

Black dot = this hospital, among the 9 AL hospitals with a price for this procedure. Full list below.

A fair price for a Colonoscopy with biopsy is about $1,150 (about 0.9× the $1,223 Medicare rate). Highlands Medical Center charges insurers about $1,144, or about $2,439 in cash — about the fair price. Located in Scottsboro, AL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Aetna✓ Cigna✓ Humana Blue Cross Blue ShieldKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$1,133	93%
Aetnamajor	$1,155	94%
Cignamajor	$1,133 - $3,333	93%
Humanamajor	$1,133	93%
Devoted Health	$1,167	95%
+ 2 smaller / regional plans	$1,133 - $1,500

Government programs also on file: Medicaid.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 2,439), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 45380.

Insurance Before you use insurance

Call your insurance company to confirm Highlands Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 45380.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Highlands Medical Center

Compare: Colonoscopy with biopsy at other AL hospitals

Insurance negotiated median for the same procedure, sorted lowest first.