CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Mercy Gilbert Medical Center

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,693

about 1.4× the $1,223 Medicare rate · typically $1,169–$1,917

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,257

Below the fair price — a good deal

about $436 under the fair price · 1.0× Medicare

Medicare pays $1,223 Fair price $1,693 This hospital $1,257

How we calculate the fair BaseRate →

How this hospital compares to other AZ hospitals

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

Cheapest $182 Priciest $1,257

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

A fair price for a Colonoscopy with biopsy is about $1,693 (about 1.4× the $1,223 Medicare rate). Mercy Gilbert Medical Center charges insurers about $1,257 — below the fair price — a good deal. Located in Gilbert, 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	$208 - $1,288	17%
Blue Cross Blue Shieldmajor	$1,257 - $4,808	103%
Aetnamajor	$1,257	103%
Cignamajor	$1,257 - $3,149	103%
Humanamajor	$1,257	103%
+ 3 smaller / regional plans	$208 - $1,257

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, 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 Mercy Gilbert 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 Mercy Gilbert Medical Center

Compare: Colonoscopy with biopsy at other AZ hospitals

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