CMS Price Transparency Data

Colonoscopy with biopsy

Facility: St Mary's General Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,826

about 1.5× the $1,223 Medicare rate · typically $1,312–$2,671

modeled estimate · not a bill or quote

What this hospital charges insurers

$2,171

Above the fair price

about $345 over the fair price · 1.8× Medicare

Medicare pays $1,223 Fair price $1,826 This hospital $2,171 Cash price $1,414 Hospital's list price $4,899

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

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

Cheapest $849 Priciest $2,171

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

A fair price for a Colonoscopy with biopsy is about $1,826 (about 1.5× the $1,223 Medicare rate). St Mary's General Hospital charges insurers about $2,171, or about $1,414 in cash — above the fair price. Located in Passaic, NJ.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $1,826. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

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	$1,415 - $4,153	116%
Blue Cross Blue Shieldmajor	$1,415	116%
Aetnamajor	$1,415 - $2,999	116%
Cignamajor	$2,079	170%
Humanamajor	$1,132	93%
AmeriHealth	$1,415	116%
Clover Health	$1,415	116%
WellCare	$1,415 - $1,910	116%
+ 4 smaller / regional plans	$1,415 - $2,508

Government programs also on file: Medicare, Military & VA.

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 1,414), 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 Mary's General 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 Mary's General Hospital

Compare: Colonoscopy with biopsy at other NJ hospitals

St Joseph's University Medical Center Inc · Paterson $849
Newton Medical Center · Newton $1,288
AHS Hospital Corp · Hackettstown $1,288
Capital Health Regional Medical Center · Trenton $1,289
Centrastate Medical Center · Freehold $1,305
Jfk University Medical Center · Edison $1,306
Carewell Health Medical Center · East Orange $1,323
The University Hospital · Newark $1,345

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