CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Memorial Hospital and Manor

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,178

about 1.0× the $1,223 Medicare rate · typically $986–$2,219

modeled estimate · not a bill or quote

What this hospital charges insurers

$987

Below the fair price — a good deal

about $191 under the fair price · 0.8× Medicare

Medicare pays $1,223 Fair price $1,178 This hospital $987 Cash price $5,638 Hospital's list price $8,054

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 $987

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Colonoscopy with biopsy is about $1,178 (about 1.0× the $1,223 Medicare rate). Memorial Hospital and Manor charges insurers about $987, or about $5,638 in cash — below the fair price — a good deal. Located in Bainbridge, GA.

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	$6,363	520%
Blue Cross Blue Shieldmajor	$6,219	509%
Aetnamajor	$987 - $7,249	81%
Cignamajor	$6,685	547%
Humanamajor	$987 - $6,443	81%
Ambetter (Centene)	$1,283	105%
Amerigroup	$5,074	415%
CareSource	$5,324	435%
WellCare	$987	81%
+ 3 smaller / regional plans	$450 - $6,443

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

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 5,638), 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 and Manor 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 and Manor

Compare: Colonoscopy with biopsy at other GA hospitals

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