CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Englewood Hospital and Medical Center

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,714

about 1.4× the $1,223 Medicare rate · typically $1,357–$2,793

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,389

Below the fair price — a good deal

about $325 under the fair price · 1.1× Medicare

Medicare pays $1,223 Fair price $1,714 This hospital $1,389

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 $1,389

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 $1,714 (about 1.4× the $1,223 Medicare rate). Englewood Hospital and Medical Center charges insurers about $1,389 — below the fair price — a good deal. Located in Englewood, NJ.

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	$1,389 - $4,954	114%
Blue Cross Blue Shieldmajor	$1,389	114%
Aetnamajor	$1,389 - $2,291	114%
Cignamajor	$5,713	467%
Humanamajor	$1,389	114%
Amerigroup	$1,389	114%
AmeriHealth	$1,389 - $2,498	114%
Clover Health	$1,389	114%
MagnaCare	$3,410 - $3,978	279%
WellCare	$1,500	123%
+ 7 smaller / regional plans	$319 - $4,865

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 Englewood Hospital and Medical 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 Englewood Hospital and Medical Center

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.