CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Westfield Memorial Hospital Inc

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$480

about 0.4× the $1,223 Medicare rate · typically $362–$1,157

modeled estimate · not a bill or quote

What this hospital charges insurers

$434

About the fair price

about $46 under the fair price · 0.4× Medicare

Medicare pays $1,223 Fair price $480 This hospital $434 Cash price $123 Hospital's list price $557

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 $434

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 $480 (about 0.4× the $1,223 Medicare rate). Westfield Memorial Hospital Inc charges insurers about $434, or about $123 in cash — about the fair price. Located in Westfield, 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	$327 - $1,507	27%
Blue Cross Blue Shieldmajor	$173 - $2,314	14%
Aetnamajor	$1,451 - $2,679	119%
Cignamajor	$315	26%
Humanamajor	$1,479	121%
AmeriHealth	$237 - $1,465	19%
Geisinger	$327 - $512	27%
Molina	$1,521	124%
+ 6 smaller / regional plans	$161 - $1,395

Government programs also on file: Medicare.

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 123), 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 Westfield Memorial Hospital Inc 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 Westfield Memorial Hospital Inc

Compare: Colonoscopy with biopsy at other NY hospitals

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