CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Phelps Memorial Health Center

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$291

about 0.2× the $1,223 Medicare rate · typically $195–$1,435

modeled estimate · not a bill or quote

What this hospital charges insurers

$298

About the fair price

about $7 over the fair price · 0.2× Medicare

Medicare pays $1,223 Fair price $291 This hospital $298 Cash price $1,040 Hospital's list price $1,155

How we calculate the fair BaseRate →

How this hospital compares to other NE hospitals

On the higher side — 7 of 8 other NE hospitals charge less.

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 $291 (about 0.2× the $1,223 Medicare rate). Phelps Memorial Health Center charges insurers about $298, or about $1,040 in cash — about the fair price. Located in Holdrege, 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 - $3,737	13%
Blue Cross Blue Shieldmajor	$165 - $3,660	13%
Aetnamajor	$430 - $3,552	35%
Ambetter (Centene)	$303 - $4,308	25%
HealthPartners	$3,660	299%
Medica	$165 - $3,622	13%
Molina	$1,110 - $1,695	91%
WellCare	$165 - $1,657	13%
+ 7 smaller / regional plans	$165 - $3,660

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 1,040), 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 Phelps Memorial Health Center 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 Phelps Memorial Health Center

Compare: Colonoscopy with biopsy at other NE hospitals

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