CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Southern Regional Medical Center

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,758

about 1.4× the $1,223 Medicare rate · typically $1,076–$2,921

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,230

Below the fair price — a good deal

about $528 under the fair price · 1.0× Medicare

Medicare pays $1,223 Fair price $1,758 This hospital $1,230 Cash price $1,194 Hospital's list price $3,657

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 $1,230

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 $1,758 (about 1.4× the $1,223 Medicare rate). Southern Regional Medical Center charges insurers about $1,230, or about $1,194 in cash — below the fair price — a good deal. Located in Riverdale, 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	$1,194	98%
Blue Cross Blue Shieldmajor	$1,194 - $2,262	98%
Aetnamajor	$1,194 - $2,297	98%
Cignamajor	$1,194 - $2,491	98%
Humanamajor	$853 - $1,170	70%
CareSource	$1,230 - $2,090	101%
Devoted Health	$1,230	101%
Oscar Health	$1,553	127%
WellCare	$1,254	103%
+ 8 smaller / regional plans	$1,194 - $1,792

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

Excludes 6 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 1,194), 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 Southern Regional 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 Southern Regional Medical Center

Compare: Colonoscopy with biopsy at other GA hospitals

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