CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Cleveland Clinic Avon Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,093

about 0.9× the $1,223 Medicare rate · typically $635–$1,223

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,093

About the fair price

0.9× Medicare

Medicare pays $1,223 Fair price $1,093 This hospital $1,093 Cash price $3,158 Hospital's list price $4,858

How we calculate the fair BaseRate →

How this hospital compares to other OH hospitals

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

Cheapest $175 Priciest $1,093

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

A fair price for a Colonoscopy with biopsy is about $1,093 (about 0.9× the $1,223 Medicare rate). Cleveland Clinic Avon Hospital charges insurers about $1,093, or about $3,158 in cash — about the fair price. Located in Avon, OH.

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	$766 - $4,338	63%
Blue Cross Blue Shieldmajor	$752 - $3,806	62%
Aetnamajor	$1,093 - $4,858	89%
Cignamajor	$1,126 - $2,531	92%
Humanamajor	$1,093	89%
CareSource	$766	63%
Devoted Health	$1,093	89%
Molina	$752	62%
Oscar Health	$1,464 - $1,868	120%
UniCare	$1,148	94%
UPMC Health Plan	$1,093 - $2,915	89%
+ 17 smaller / regional plans	$752 - $4,372

Excludes 2 rental-network / third-party entries (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 3,158), 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 Cleveland Clinic Avon 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 Cleveland Clinic Avon Hospital

Compare: Colonoscopy with biopsy at other OH hospitals

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