CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Lower Keys Medical Center

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,568

about 1.3× the $1,223 Medicare rate · typically $1,013–$2,223

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,328

Below the fair price — a good deal

about $240 under the fair price · 1.1× Medicare

Medicare pays $1,223 Fair price $1,568 This hospital $1,328 Cash price $3,902 Hospital's list price $14,453

How we calculate the fair BaseRate →

How this hospital compares to other FL hospitals

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

Cheapest $135 Priciest $1,328

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 $1,568 (about 1.3× the $1,223 Medicare rate). Lower Keys Medical Center charges insurers about $1,328, or about $3,902 in cash — below the fair price — a good deal. Located in Key West, 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	$62 - $11,114	5%
Blue Cross Blue Shieldmajor	$1,317 - $14,654	108%
Aetnamajor	$10,088	825%
Cignamajor	$8,527	697%
Humanamajor	$1,001 - $1,317	82%
Amerigroup	$1,069	87%
AvMed	$12,285	1005%
Molina	$1,098	90%
Simply Healthcare	$1,069 - $3,000	87%
WellCare	$1,069	87%
+ 12 smaller / regional plans	$972 - $14,453

Government programs also on file: Medicare, 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 3,902), 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 Lower Keys 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 Lower Keys Medical Center

Compare: Colonoscopy with biopsy at other FL hospitals

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