CMS Price Transparency Data

Colonoscopy with biopsy

Facility: St James Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,529

about 1.3× the $1,223 Medicare rate · typically $1,210–$1,540

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,214

Below the fair price — a good deal

about $315 under the fair price · 1.0× Medicare

Medicare pays $1,223 Fair price $1,529 This hospital $1,214

How we calculate the fair BaseRate →

How this hospital compares to other MT hospitals

On the higher side — 6 of 8 other MT hospitals charge less.

Cheapest $311 Priciest $1,271

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

A fair price for a Colonoscopy with biopsy is about $1,529 (about 1.3× the $1,223 Medicare rate). St James Hospital charges insurers about $1,214 — below the fair price — a good deal. Located in Butte, MT.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Humana Blue Cross Blue ShieldAetnaCignaKaiser 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	$1,203	98%
Humanamajor	$1,214	99%
+ 2 smaller / regional plans	$2,476 - $3,360

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 St James 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 St James Hospital

Compare: Colonoscopy with biopsy at other MT hospitals

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