CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Breckinridge Memorial Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$380

about 0.3× the $1,223 Medicare rate · typically $159–$1,362

modeled estimate · not a bill or quote

What this hospital charges insurers

$171

Below the fair price — a good deal

about $209 under the fair price · 0.1× Medicare

Medicare pays $1,223 Fair price $380 This hospital $171 Cash price $555 Hospital's list price $1,110

How we calculate the fair BaseRate →

How this hospital compares to other KY hospitals

Lowest price of the 9 KY hospitals we have prices for — a strong deal.

Cheapest $171 Priciest $395

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Colonoscopy with biopsy is about $380 (about 0.3× the $1,223 Medicare rate). Breckinridge Memorial Hospital charges insurers about $171, or about $555 in cash — below the fair price — a good deal. Located in Hardinsburg, KY.

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✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser 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	$171	14%
Blue Cross Blue Shieldmajor	$171 - $1,110	14%
Aetnamajor	$171 - $1,110	14%
Ambetter (Centene)	$171	14%
CareSource	$171	14%
Molina	$171	14%
WellCare	$171 - $1,110	14%
+ 1 smaller / regional plan	$171

Government programs also on file: Military & VA.

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 555), 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 Breckinridge Memorial 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 Breckinridge Memorial Hospital

Compare: Colonoscopy with biopsy at other KY hospitals

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