CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Boone County Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$315

about 0.3× the $1,223 Medicare rate · typically $177–$1,135

modeled estimate · not a bill or quote

What this hospital charges insurers

$314

About the fair price

about $1 under the fair price · 0.3× Medicare

Medicare pays $1,223 Fair price $315 This hospital $314 Cash price $480 Hospital's list price $600

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 $314

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 $315 (about 0.3× the $1,223 Medicare rate). Boone County Hospital charges insurers about $314, or about $480 in cash — about the fair price. Located in Boone, IA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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	$190 - $292	16%
Blue Cross Blue Shieldmajor	$391	32%
Aetnamajor	$168 - $616	14%
Humanamajor	$165 - $563	13%
Amerigroup	$167	14%
HealthPartners	$506	41%
Meridian	$552 - $626	45%
+ 7 smaller / regional plans	$165 - $638

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

Excludes 4 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 480), 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 Boone County 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 Boone County Hospital

Compare: Colonoscopy with biopsy at other IA hospitals

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