CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Valleywise Health Medical Center

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$732

about 0.6× the $1,223 Medicare rate · typically $447–$1,173

modeled estimate · not a bill or quote

What this hospital charges insurers

$469

Below the fair price — a good deal

about $263 under the fair price · 0.4× Medicare

Medicare pays $1,223 Fair price $732 This hospital $469 Cash price $1,468 Hospital's list price $2,130

How we calculate the fair BaseRate →

How this hospital compares to other AZ hospitals

On the higher side — 6 of 8 other AZ hospitals charge less.

Cheapest $182 Priciest $752

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Colonoscopy with biopsy is about $732 (about 0.6× the $1,223 Medicare rate). Valleywise Health Medical Center charges insurers about $469, or about $1,468 in cash — below the fair price — a good deal. Located in Phoenix, AZ.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$204 - $1,850	17%
Blue Cross Blue Shieldmajor	$175 - $2,764	14%
Aetnamajor	$174 - $2,288	14%
Cignamajor	$223 - $2,816	18%
Humanamajor	$385 - $1,277	31%
Banner Health	$175 - $1,277	14%
Devoted Health	$175 - $1,277	14%
Health Net	$148 - $2,442	12%
Molina	$189 - $1,405	15%
Oscar Health	$201 - $3,500	16%
+ 12 smaller / regional plans	$175 - $2,640

Government programs also on file: Military & VA.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 1,468), 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 Valleywise Health 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 Valleywise Health Medical Center

Compare: Colonoscopy with biopsy at other AZ hospitals

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