CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Jamaica Hospital Medical Center

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,349

about 1.1× the $1,223 Medicare rate · typically $599–$1,700

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,576

Above the fair price

about $227 over the fair price · 1.3× Medicare

Medicare pays $1,223 Fair price $1,349 This hospital $1,576 Cash price $3,000 Hospital's list price $3,000

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 $1,576

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 $1,349 (about 1.1× the $1,223 Medicare rate). Jamaica Hospital Medical Center charges insurers about $1,576, or about $3,000 in cash — above the fair price. Located in Jamaica, NY.

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 $1,349. 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	$882 - $4,215	72%
Blue Cross Blue Shieldmajor	$3,005	246%
Aetnamajor	$1,486 - $2,914	122%
Cignamajor	$4,250	348%
Humanamajor	$1,576	129%
EmblemHealth	$2,453	201%
Fidelis Care	$1,412 - $1,486	115%
MagnaCare	$1,709 - $4,555	140%
Oscar Health	$4,018	329%
WellCare	$1,546	126%
+ 17 smaller / regional plans	$274 - $5,159

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 3,000), 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 Jamaica Hospital 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 Jamaica Hospital Medical Center

Compare: Colonoscopy with biopsy at other NY hospitals

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