CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Memorial Hospital Pembroke

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,353

about 1.1× the $1,223 Medicare rate · typically $1,061–$2,133

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,525

About the fair price

about $172 over the fair price · 1.2× Medicare

Medicare pays $1,223 Fair price $1,353 This hospital $1,525 Cash price $4,388 Hospital's list price $6,269

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 $1,525

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 $1,353 (about 1.1× the $1,223 Medicare rate). Memorial Hospital Pembroke charges insurers about $1,525, or about $4,388 in cash — about the fair price. Located in Pembroke Pines, FL.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Aetna✓ Cigna✓ Humana Blue Cross Blue ShieldKaiser 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	$1,500	123%
Aetnamajor	$1,066 - $1,387	87%
Cignamajor	$1,078 - $2,877	88%
Humanamajor	$1,350	110%
AvMed	$757 - $2,966	62%
Health Net	$2,006	164%
WellCare	$1,325 - $1,362	108%
+ 28 smaller / regional plans	$718 - $5,329

Excludes 3 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 4,388), 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 Memorial Hospital Pembroke 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 Memorial Hospital Pembroke

Compare: Colonoscopy with biopsy at other FL hospitals

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