CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Centrastate Medical Center

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,592

about 1.3× the $1,223 Medicare rate · typically $1,319–$2,602

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,305

Below the fair price — a good deal

about $287 under the fair price · 1.1× Medicare

Medicare pays $1,223 Fair price $1,592 This hospital $1,305 Cash price $1,501 Hospital's list price $12,364

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

A typical price — 4 charge more and 4 charge less, among the 9 NJ hospitals compared.

Cheapest $849 Priciest $1,346

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 $1,592 (about 1.3× the $1,223 Medicare rate). Centrastate Medical Center charges insurers about $1,305, or about $1,501 in cash — below the fair price — a good deal. Located in Freehold, NJ.

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

✓ Blue Cross Blue Shield✓ Aetna✓ Cigna UnitedHealthcareHumanaKaiser 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
Blue Cross Blue Shieldmajor	$1,305	107%
Aetnamajor	$1,305 - $1,827	107%
Cignamajor	$1,305	107%
Ambetter (Centene)	$1,305	107%
AmeriHealth	$1,305 - $4,096	107%
UPMC Health Plan	$1,305	107%
WellCare	$1,305	107%
+ 13 smaller / regional plans	$388 - $12,000

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

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 (about 1,501), 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 Centrastate 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 Centrastate 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
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.