CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Beacon Plainwell

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$673

about 0.6× the $1,223 Medicare rate · typically $220–$1,257

modeled estimate · not a bill or quote

What this hospital charges insurers

$456

Below the fair price — a good deal

about $217 under the fair price · 0.4× Medicare

Medicare pays $1,223 Fair price $673 This hospital $456

How we calculate the fair BaseRate →

How this hospital compares to other MI hospitals

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

Cheapest $150 Priciest $456

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 $673 (about 0.6× the $1,223 Medicare rate). Beacon Plainwell charges insurers about $456 — below the fair price — a good deal. Located in Plainwell, MI.

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✓ Cigna Blue Cross Blue ShieldHumanaKaiser 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	$456	37%
Aetnamajor	$456	37%
Cignamajor	$3,657	299%
+ 2 smaller / regional plans	$456

Government programs also on file: Medicaid.

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 Beacon Plainwell 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 Beacon Plainwell

Compare: Colonoscopy with biopsy at other MI hospitals

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