CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$622

about 0.5× the $1,223 Medicare rate · typically $284–$999

modeled estimate · not a bill or quote

What this hospital charges insurers

$189

Below the fair price — a good deal

about $433 under the fair price · 0.2× Medicare

Medicare pays $1,223 Fair price $622 This hospital $189

How we calculate the fair BaseRate →

How this hospital compares to other MI hospitals

One of the lower prices — 6 of 8 other MI hospitals charge more for the same procedure.

Cheapest $150 Priciest $280

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

A fair price for a Colonoscopy with biopsy is about $622 (about 0.5× the $1,223 Medicare rate). Munson Healthcare Otsego Memorial Hospital charges insurers about $189 — below the fair price — a good deal. Located in Gaylord, MI.

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	$127 - $624	10%
Blue Cross Blue Shieldmajor	$58 - $624	5%
Aetnamajor	$177	14%
Cignamajor	$362 - $1,129	30%
Humanamajor	$175	14%
Meridian	$127 - $624	10%
Molina	$127 - $624	10%
Priority Health	$127 - $1,129	10%
+ 7 smaller / regional plans	$127 - $624

Government programs also on file: Medicare.

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, 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 Munson Healthcare Otsego 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 Munson Healthcare Otsego Memorial Hospital

Compare: Colonoscopy with biopsy at other MI hospitals

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