CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Hermann Area District Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$502

about 0.4× the $1,223 Medicare rate · typically $190–$1,646

modeled estimate · not a bill or quote

What this hospital charges insurers

$451

Below the fair price — a good deal

about $51 under the fair price · 0.4× Medicare

Medicare pays $1,223 Fair price $502 This hospital $451 Cash price $857 Hospital's list price $1,429

How we calculate the fair BaseRate →

How this hospital compares to other MO hospitals

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

Cheapest $171 Priciest $451

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

A fair price for a Colonoscopy with biopsy is about $502 (about 0.4× the $1,223 Medicare rate). Hermann Area District Hospital charges insurers about $451, or about $857 in cash — below the fair price — a good deal. Located in Hermann, MO.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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	$459 - $609	38%
Blue Cross Blue Shieldmajor	$459 - $1,180	38%
Aetnamajor	$632 - $1,378	52%
Humanamajor	$620 - $638	51%
Ambetter (Centene)	$442 - $1,021	36%
HealthLink	$915 - $942	75%
WellCare	$632 - $651	52%
+ 7 smaller / regional plans	$426 - $1,305

Government programs also on file: Military & VA.

Excludes 3 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 857), 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 Hermann Area District 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 Hermann Area District Hospital

Compare: Colonoscopy with biopsy at other MO hospitals

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