CMS Price Transparency Data

Colonoscopy with biopsy

Facility: The Children's Mercy Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$527

about 0.4× the $1,223 Medicare rate · typically $304–$2,027

modeled estimate · not a bill or quote

What this hospital charges insurers

$473

Below the fair price — a good deal

about $54 under the fair price · 0.4× Medicare

Medicare pays $1,223 Fair price $527 This hospital $473 Cash price $463 Hospital's list price $965

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 $473

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 $527 (about 0.4× the $1,223 Medicare rate). The Children's Mercy Hospital charges insurers about $473, or about $463 in cash — below the fair price — a good deal. Located in Kansas City, MO.

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	$411 - $769	34%
Blue Cross Blue Shieldmajor	$441 - $760	36%
Aetnamajor	$443 - $560	36%
Cignamajor	$535	44%
Humanamajor	$478	39%
Health Net	$714	58%
HealthLink	$247	20%
Medica	$563	46%
+ 11 smaller / regional plans	$265 - $704

Government programs also on file: Medicaid.

Excludes 2 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 463), 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 The Children's Mercy 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 The Children's Mercy Hospital

Compare: Colonoscopy with biopsy at other MO hospitals

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