CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Kosciusko Community Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,155

about 0.9× the $1,223 Medicare rate · typically $853–$2,737

modeled estimate · not a bill or quote

Medicare pays $1,223 Fair price $1,155 Cash price $257 Hospital's list price $989

How we calculate the fair BaseRate →

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	$245 - $6,693	20%
Blue Cross Blue Shieldmajor	$1,334 - $5,203	109%
Aetnamajor	$258 - $6,769	21%
Cignamajor	$398 - $8,042	33%
Humanamajor	$1,334 - $3,122	109%
CareSource	$2,401 - $3,122	196%
Devoted Health	$1,361	111%
Health Net	$585 - $11,833	48%
+ 19 smaller / regional plans	$132 - $11,960

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

Excludes 9 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 257), 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 Kosciusko Community 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 Kosciusko Community Hospital

Compare: Colonoscopy with biopsy at other IN hospitals

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