CMS Price Transparency Data

Colonoscopy with biopsy

Facility: St Francis Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,753

about 1.4× the $1,223 Medicare rate · typically $906–$3,037

modeled estimate · not a bill or quote

What this hospital charges insurers

$2,809

Above the fair price

about $1,056 over the fair price · 2.3× Medicare

Medicare pays $1,223 Fair price $1,753 This hospital $2,809 Cash price $8,231

How we calculate the fair BaseRate →

How this hospital compares to other DE hospitals

Highest price of the 6 DE hospitals we have prices for — worth calling around.

Cheapest $415 Priciest $2,809

Black dot = this hospital, among the 6 DE hospitals with a price for this procedure. Full list below.

A fair price for a Colonoscopy with biopsy is about $1,753 (about 1.4× the $1,223 Medicare rate). St Francis Hospital charges insurers about $2,809, or about $8,231 in cash — above the fair price. Located in Wilmington, DE.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $1,753. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

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

✓ Blue Cross Blue Shield✓ Aetna✓ Cigna UnitedHealthcareHumanaKaiser 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
Blue Cross Blue Shieldmajor	$1,274 - $4,987	104%
Aetnamajor	$1,348 - $1,528	110%
Cignamajor	$1,286	105%
AmeriHealth	$4,987	408%
+ 4 smaller / regional plans	$871 - $2,809

Government programs also on file: Medicare.

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 8,231), 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 St Francis Hospital 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 St Francis Hospital

Compare: Colonoscopy with biopsy at other DE hospitals

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