CMS Price Transparency Data

Colonoscopy with biopsy

Facility: St Lukes Regional Medical Center

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$802

about 0.7× the $1,223 Medicare rate · typically $604–$1,021

modeled estimate · not a bill or quote

What this hospital charges insurers

$664

Below the fair price — a good deal

about $138 under the fair price · 0.5× Medicare

Medicare pays $1,223 Fair price $802 This hospital $664 Cash price $1,047 Hospital's list price $1,309

How we calculate the fair BaseRate →

How this hospital compares to other IA hospitals

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

Cheapest $165 Priciest $664

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

A fair price for a Colonoscopy with biopsy is about $802 (about 0.7× the $1,223 Medicare rate). St Lukes Regional Medical Center charges insurers about $664, or about $1,047 in cash — below the fair price — a good deal. Located in Sioux City, IA.

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	$188 - $3,147	15%
Blue Cross Blue Shieldmajor	$183 - $1,172	15%
Aetnamajor	$179 - $2,883	15%
Cignamajor	$478	39%
Humanamajor	$188 - $1,207	15%
Amerigroup	$1,044	85%
HealthPartners	$484 - $1,760	40%
Molina	$183 - $1,172	15%
+ 4 smaller / regional plans	$188 - $1,965

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 1,047), 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 St Lukes 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 St Lukes Regional Medical Center

Compare: Colonoscopy with biopsy at other IA hospitals

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