CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Nicholas H Noyes Memorial Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$456

about 0.4× the $1,223 Medicare rate · typically $249–$1,402

modeled estimate · not a bill or quote

What this hospital charges insurers

$409

Below the fair price — a good deal

about $47 under the fair price · 0.3× Medicare

Medicare pays $1,223 Fair price $456 This hospital $409 Hospital's list price $1,338

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 $409

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 $456 (about 0.4× the $1,223 Medicare rate). Nicholas H Noyes Memorial Hospital charges insurers about $409 — below the fair price — a good deal. Located in Dansville, NY.

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	$171 - $2,937	14%
Blue Cross Blue Shieldmajor	$134 - $2,606	11%
Aetnamajor	$161 - $1,494	13%
Cignamajor	$241 - $3,552	20%
Humanamajor	$1,494	122%
CDPHP	$486 - $1,067	40%
Fidelis Care	$256 - $558	21%
Independent Health	$242 - $621	20%
MVP Health Care	$175 - $3,440	14%
+ 2 smaller / regional plans	$2,402 - $3,185

Government programs also on file: Medicare, Medicaid.

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 Nicholas H Noyes Memorial 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 (%)

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Other Procedures at Nicholas H Noyes Memorial Hospital

Compare: Colonoscopy with biopsy at other NY hospitals

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