CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Saint Vincent Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$361

about 0.3× the $1,223 Medicare rate · typically $343–$828

modeled estimate · not a bill or quote

What this hospital charges insurers

$361

About the fair price

0.3× Medicare

Medicare pays $1,223 Fair price $361 This hospital $361 Cash price $100 Hospital's list price $557

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

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

Cheapest $225 Priciest $361

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

A fair price for a Colonoscopy with biopsy is about $361 (about 0.3× the $1,223 Medicare rate). Saint Vincent Hospital charges insurers about $361, or about $100 in cash — about the fair price. Located in Erie, PA.

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 - $34,649	27%
Blue Cross Blue Shieldmajor	$173 - $2,022	14%
Aetnamajor	$248 - $2,612	20%
Cignamajor	$315 - $2,737	26%
Humanamajor	$1,360	111%
AmeriHealth	$237 - $1,347	19%
Geisinger	$327 - $512	27%
Medical Mutual	$2,737	224%
Molina	$1,398	114%
+ 7 smaller / regional plans	$161 - $1,548

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 100), 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 Saint Vincent 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 Saint Vincent Hospital

Compare: Colonoscopy with biopsy at other PA hospitals

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