CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Grady Memorial Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,967

about 1.6× the $1,223 Medicare rate · typically $589–$2,942

modeled estimate · not a bill or quote

What this hospital charges insurers

$597

Below the fair price — a good deal

about $1,370 under the fair price · 0.5× Medicare

Medicare pays $1,223 Fair price $1,967 This hospital $597

How we calculate the fair BaseRate →

How this hospital compares to other GA hospitals

A typical price — 4 charge more and 4 charge less, among the 9 GA hospitals compared.

Cheapest $236 Priciest $987

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 $1,967 (about 1.6× the $1,223 Medicare rate). Grady Memorial Hospital charges insurers about $597 — below the fair price — a good deal. Located in Atlanta, GA.

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	$195 - $2,880	16%
Blue Cross Blue Shieldmajor	$195 - $5,612	16%
Aetnamajor	$195 - $2,891	16%
Cignamajor	$195 - $2,836	16%
Humanamajor	$195 - $1,173	16%
Kaiser Permanentemajor	$195 - $1,173	16%
Ambetter (Centene)	$195 - $1,173	16%
Amerigroup	$316	26%
CareSource	$311 - $1,877	25%
Clover Health	$204 - $1,232	17%
Oscar Health	$274 - $1,945	22%
WellCare	$195 - $1,173	16%
+ 1 smaller / regional plan	$204 - $1,232

Government programs also on file: Medicare, Medicaid, Military & VA.

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, 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 Grady Memorial 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 Grady Memorial Hospital

Compare: Colonoscopy with biopsy at other GA hospitals

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