CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Queens Hospital Center

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,290

about 1.1× the $1,223 Medicare rate · typically $619–$1,590

modeled estimate · not a bill or quote

What this hospital charges insurers

$947

Below the fair price — a good deal

about $343 under the fair price · 0.8× Medicare

Medicare pays $1,223 Fair price $1,290 This hospital $947 Cash price $1,365 Hospital's list price $4,076

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 $947

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 $1,290 (about 1.1× the $1,223 Medicare rate). Queens Hospital Center charges insurers about $947, or about $1,365 in cash — below the fair price — a good deal. Located in Jamaica, 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	$434 - $3,275	35%
Blue Cross Blue Shieldmajor	$219 - $3,402	18%
Aetnamajor	$240 - $2,177	20%
Cignamajor	$1,500 - $4,285	123%
Fidelis Care	$219 - $2,131	18%
MagnaCare	$320 - $3,190	26%
Oscar Health	$274 - $4,454	22%
WellCare	$223 - $2,552	18%
+ 15 smaller / regional plans	$110 - $4,821

Government programs also on file: 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 1,365), 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 Queens Hospital 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 Queens Hospital Center

Compare: Colonoscopy with biopsy at other NY hospitals

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