CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Emory University Hospital Midtown

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$2,100

about 1.7× the $1,223 Medicare rate · typically $1,069–$3,297

modeled estimate · not a bill or quote

What this hospital charges insurers

$3,051

Above the fair price

about $951 over the fair price · 2.5× Medicare

Medicare pays $1,223 Fair price $2,100 This hospital $3,051 Cash price $3,732 Hospital's list price $3,732

How we calculate the fair BaseRate →

How this hospital compares to other GA hospitals

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

Cheapest $236 Priciest $3,051

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

A fair price for a Colonoscopy with biopsy is about $2,100 (about 1.7× the $1,223 Medicare rate). Emory University Hospital Midtown charges insurers about $3,051, or about $3,732 in cash — above the fair price. Located in Atlanta, GA.

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 $2,100. 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.

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	$2,912 - $3,425	238%
Blue Cross Blue Shieldmajor	$1,228 - $5,051	100%
Aetnamajor	$1,240 - $3,826	101%
Cignamajor	$1,252 - $4,797	102%
Humanamajor	$5,346	437%
Kaiser Permanentemajor	$3,051	250%
Ambetter (Centene)	$2,577	211%
Clover Health	$1,276	104%
Devoted Health	$1,215	99%
Oscar Health	$4,249	348%
WellCare	$1,288	105%

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 3,732), 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 Emory University Hospital Midtown 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 Emory University Hospital Midtown

Compare: Colonoscopy with biopsy at other GA hospitals

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