CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Memorial Health Care Systems

Billing Code: 45380 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$381

about 0.3× the $1,223 Medicare rate · typically $178–$2,223

modeled estimate · not a bill or quote

What this hospital charges insurers

$179

Below the fair price — a good deal

about $202 under the fair price · 0.1× Medicare

Medicare pays $1,223 Fair price $381 This hospital $179 Cash price $979 Hospital's list price $979

How we calculate the fair BaseRate →

How this hospital compares to other NE hospitals

Lowest price of the 9 NE hospitals we have prices for — a strong deal.

Cheapest $179 Priciest $316

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Colonoscopy with biopsy is about $381 (about 0.3× the $1,223 Medicare rate). Memorial Health Care Systems charges insurers about $179, or about $979 in cash — below the fair price — a good deal. Located in Seward, NE.

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✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser 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	$165 - $408	13%
Blue Cross Blue Shieldmajor	$165 - $878	13%
Aetnamajor	$959	78%
Ambetter (Centene)	$76	6%
Medica	$165 - $179	13%
Molina	$408	33%
WellCare	$169	14%
+ 2 smaller / regional plans	$165 - $408

Government programs also on file: Military & VA.

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 979), 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 Memorial Health Care Systems 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 Memorial Health Care Systems

Compare: Colonoscopy with biopsy at other NE hospitals

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