CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Albany Medical Center Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$368

about 0.3× the $1,223 Medicare rate · typically $256–$1,310

modeled estimate · not a bill or quote

What this hospital charges insurers

$422

About the fair price

about $54 over the fair price · 0.3× Medicare

Medicare pays $1,223 Fair price $368 This hospital $422 Cash price $490 Hospital's list price $980

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

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

Cheapest $192 Priciest $422

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

A fair price for a Colonoscopy with biopsy is about $368 (about 0.3× the $1,223 Medicare rate). Albany Medical Center Hospital charges insurers about $422, or about $490 in cash — about the fair price. Located in Albany, NY.

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	$186 - $2,227	15%
Blue Cross Blue Shieldmajor	$153 - $5,093	13%
Aetnamajor	$193 - $5,476	16%
Cignamajor	$282 - $712	23%
CDPHP	$126 - $5,076	10%
Fidelis Care	$146 - $2,386	12%
MagnaCare	$364 - $2,227	30%
MVP Health Care	$181 - $4,563	15%
+ 8 smaller / regional plans	$173 - $7,595

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 490), 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 Albany Medical Center 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 Albany Medical Center Hospital

Compare: Colonoscopy with biopsy at other NY hospitals

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