CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Saint Francis Hospital-Evanston

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,280

about 1.0× the $1,223 Medicare rate · typically $1,197–$1,632

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,288

About the fair price

about $8 over the fair price · 1.1× Medicare

Medicare pays $1,223 Fair price $1,280 This hospital $1,288 Cash price $1,276 Hospital's list price $7,313

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

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

Cheapest $181 Priciest $1,288

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

A fair price for a Colonoscopy with biopsy is about $1,280 (about 1.0× the $1,223 Medicare rate). Saint Francis Hospital-Evanston charges insurers about $1,288, or about $1,276 in cash — about the fair price. Located in Evanston, IL.

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	$1,276 - $2,821	104%
Blue Cross Blue Shieldmajor	$1,212 - $1,786	99%
Aetnamajor	$1,238 - $2,571	101%
Cignamajor	$488 - $4,550	40%
Humanamajor	$1,238 - $1,404	101%
Ambetter (Centene)	$2,067	169%
Devoted Health	$1,276	104%
Health Net	$1,531	125%
HealthPartners	$1,276 - $1,467	104%
Meridian	$1,299 - $1,340	106%
Molina	$1,299 - $1,914	106%
WellCare	$1,276	104%
+ 10 smaller / regional plans	$197 - $1,978

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

Excludes 2 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 1,276), 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 Saint Francis Hospital-Evanston 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 Saint Francis Hospital-Evanston

Compare: Colonoscopy with biopsy at other IL hospitals

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