CMS Price Transparency Data

Colonoscopy with biopsy

Facility: St Joseph's University Medical Center Inc

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,472

about 1.2× the $1,223 Medicare rate · typically $729–$2,405

modeled estimate · not a bill or quote

What this hospital charges insurers

$849

Below the fair price — a good deal

about $623 under the fair price · 0.7× Medicare

Medicare pays $1,223 Fair price $1,472 This hospital $849 Cash price $4,547 Hospital's list price $4,547

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

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

Cheapest $849 Priciest $1,346

Black dot = this hospital, among the 9 NJ 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 $1,472 (about 1.2× the $1,223 Medicare rate). St Joseph's University Medical Center Inc charges insurers about $849, or about $4,547 in cash — below the fair price — a good deal. Located in Paterson, NJ.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$145 - $3,425	12%
Blue Cross Blue Shieldmajor	$194 - $4,048	16%
Aetnamajor	$194 - $6,397	16%
Cignamajor	$1,406 - $4,547	115%
Ambetter (Centene)	$194 - $2,132	16%
AmeriHealth	$194 - $2,895	16%
Clover Health	$194 - $1,422	16%
Fidelis Care	$145 - $1,493	12%
Health Net	$507 - $4,092	41%
MagnaCare	$3,183	260%
Oscar Health	$4,283	350%
+ 4 smaller / regional plans	$194 - $3,155

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 4,547), 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 Joseph's University Medical Center Inc 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 Joseph's University Medical Center Inc

Compare: Colonoscopy with biopsy at other NJ hospitals

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
Inspira Medical Center Vineland · Vineland $1,346

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