CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Anderson Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,538

about 1.3× the $1,223 Medicare rate · typically $1,237–$2,588

modeled estimate · not a bill or quote

What this hospital charges insurers

$2,705

Well above the fair price

about $1,167 over the fair price · 2.2× Medicare

Medicare pays $1,223 Fair price $1,538 This hospital $2,705 Cash price $7,778 Hospital's list price $12,963

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 $2,705

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 $1,538 (about 1.3× the $1,223 Medicare rate). Anderson Hospital charges insurers about $2,705, or about $7,778 in cash — well above the fair price. Located in Maryville, IL.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $1,538. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Aetna✓ Humana Blue Cross Blue ShieldCignaKaiser 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	$459 - $4,915	38%
Aetnamajor	$1,166 - $4,915	95%
Humanamajor	$459 - $4,915	38%
Ambetter (Centene)	$7,265	594%
CareSource	$1,189 - $2,759	97%
+ 4 smaller / regional plans	$5,010 - $12,526

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 7,778), 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 Anderson 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 Anderson Hospital

Compare: Colonoscopy with biopsy at other IL hospitals

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