CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Nationwide Children's Hospital Toledo, LLC

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$749

about 0.6× the $1,223 Medicare rate · typically $556–$1,083

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,011

Above the fair price

about $262 over the fair price · 0.8× Medicare

Medicare pays $1,223 Fair price $749 This hospital $1,011 Cash price $1,244 Hospital's list price $2,074

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 $1,011

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 $749 (about 0.6× the $1,223 Medicare rate). Nationwide Children's Hospital Toledo, LLC charges insurers about $1,011, or about $1,244 in cash — above the fair price. Located in Toledo, OH.

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 $749. 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	$211 - $2,128	17%
Blue Cross Blue Shieldmajor	$182 - $1,857	15%
Aetnamajor	$711	58%
Cignamajor	$561	46%
Humanamajor	$1,016	83%
AmeriHealth	$213 - $1,016	17%
CareSource	$174 - $1,284	14%
Molina	$1,006 - $1,415	82%
Paramount	$174	14%
+ 5 smaller / regional plans	$131 - $3,668

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 1,244), 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 Nationwide Children's Hospital Toledo, LLC 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 Nationwide Children's Hospital Toledo, LLC

Compare: Colonoscopy with biopsy at other OH hospitals

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