CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Claiborne Memorial Medical Center

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$953

about 0.8× the $1,223 Medicare rate · typically $509–$1,416

modeled estimate · not a bill or quote

What this hospital charges insurers

$651

Below the fair price — a good deal

about $302 under the fair price · 0.5× Medicare

Medicare pays $1,223 Fair price $953 This hospital $651 Cash price $1,400 Hospital's list price $1,400

How we calculate the fair BaseRate →

How this hospital compares to other LA hospitals

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

Cheapest $210 Priciest $651

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

A fair price for a Colonoscopy with biopsy is about $953 (about 0.8× the $1,223 Medicare rate). Claiborne Memorial Medical Center charges insurers about $651, or about $1,400 in cash — below the fair price — a good deal. Located in Homer, LA.

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	$468 - $1,400	38%
Blue Cross Blue Shieldmajor	$2,435	199%
Aetnamajor	$468 - $910	38%
Cignamajor	$1,050	86%
Humanamajor	$468 - $1,400	38%
Ambetter (Centene)	$250	20%
AmeriHealth	$468 - $602	38%
GEHA	$980	80%
+ 59 smaller / regional plans	$468 - $1,400

Government programs also on file: Medicaid.

Excludes 5 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 1,400), 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 Claiborne Memorial Medical Center 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 Claiborne Memorial Medical Center

Compare: Colonoscopy with biopsy at other LA hospitals

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