CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Cleveland Clinic Indian River Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$386

about 0.3× the $1,223 Medicare rate · typically $327–$1,180

modeled estimate · not a bill or quote

What this hospital charges insurers

$355

About the fair price

about $31 under the fair price · 0.3× Medicare

Medicare pays $1,223 Fair price $386 This hospital $355 Cash price $995 Hospital's list price $1,531

How we calculate the fair BaseRate →

How this hospital compares to other FL hospitals

A typical price — 5 charge more and 3 charge less, among the 9 FL hospitals compared.

Cheapest $135 Priciest $558

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

A fair price for a Colonoscopy with biopsy is about $386 (about 0.3× the $1,223 Medicare rate). Cleveland Clinic Indian River Hospital charges insurers about $355, or about $995 in cash — about the fair price. Located in Vero Beach, FL.

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 - $2,728	17%
Blue Cross Blue Shieldmajor	$204 - $4,699	17%
Aetnamajor	$245 - $4,061	20%
Cignamajor	$326 - $418	27%
Humanamajor	$1,184	97%
AmeriHealth	$327	27%
AvMed	$204 - $2,710	17%
Devoted Health	$1,302	106%
Molina	$327	27%
WellCare	$204 - $1,184	17%
WellMed	$215 - $1,184	18%
+ 11 smaller / regional plans	$204 - $1,243

Government programs also on file: Medicaid.

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 995), 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 Cleveland Clinic Indian River 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 Cleveland Clinic Indian River Hospital

Compare: Colonoscopy with biopsy at other FL hospitals

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