CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Carolinas Medical Center-Northeast

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$469

about 0.4× the $1,223 Medicare rate · typically $275–$893

modeled estimate · not a bill or quote

What this hospital charges insurers

$491

About the fair price

about $22 over the fair price · 0.4× Medicare

Medicare pays $1,223 Fair price $469 This hospital $491

How we calculate the fair BaseRate →

How this hospital compares to other NC hospitals

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

Cheapest $318 Priciest $491

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

A fair price for a Colonoscopy with biopsy is about $469 (about 0.4× the $1,223 Medicare rate). Carolinas Medical Center-Northeast charges insurers about $491 — about the fair price. Located in Concord, NC.

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	$190 - $1,181	16%
Blue Cross Blue Shieldmajor	$542 - $714	44%
Aetnamajor	$189 - $1,161	15%
Cignamajor	$183 - $1,177	15%
Humanamajor	$187 - $1,144	15%
AmeriHealth	$203	17%
Health Net	$464	38%
WellCare	$203	17%
+ 8 smaller / regional plans	$201 - $1,402

Excludes 1 rental-network / third-party entry (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, 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 Carolinas Medical Center-Northeast 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 Carolinas Medical Center-Northeast

Compare: Colonoscopy with biopsy at other NC hospitals

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