CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Adventist Health Lodi Memorial

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,194

about 1.0× the $1,223 Medicare rate · typically $311–$1,567

modeled estimate · not a bill or quote

What this hospital charges insurers

$398

Below the fair price — a good deal

about $796 under the fair price · 0.3× Medicare

Medicare pays $1,223 Fair price $1,194 This hospital $398 Cash price $65 Hospital's list price $927

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

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

Cheapest $165 Priciest $398

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

A fair price for a Colonoscopy with biopsy is about $1,194 (about 1.0× the $1,223 Medicare rate). Adventist Health Lodi Memorial charges insurers about $398, or about $65 in cash — below the fair price — a good deal. Located in Lodi, CA.

What each insurance company pays

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

6 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	$178 - $4,954	15%
Blue Cross Blue Shieldmajor	$161 - $1,578	13%
Aetnamajor	$336 - $16,197	27%
Cignamajor	$235 - $1,750	19%
Humanamajor	$178 - $1,578	15%
Kaiser Permanentemajor	$203 - $1,578	17%
Bright Health	$3,157	258%
Health Net	$178 - $1,578	15%
+ 12 smaller / regional plans	$129 - $2,841

Government programs also on file: Medicaid, Military & VA.

Excludes 5 rental-network / third-party entries (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 65), 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 Adventist Health Lodi Memorial 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 Adventist Health Lodi Memorial

Compare: Colonoscopy with biopsy at other CA hospitals

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