CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Chan Soon- Shiong Medical Center at Windber

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$577

about 0.5× the $1,223 Medicare rate · typically $320–$1,140

modeled estimate · not a bill or quote

What this hospital charges insurers

$451

Below the fair price — a good deal

about $126 under the fair price · 0.4× Medicare

Medicare pays $1,223 Fair price $577 This hospital $451 Cash price $598 Hospital's list price $703

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 $451

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 $577 (about 0.5× the $1,223 Medicare rate). Chan Soon- Shiong Medical Center at Windber charges insurers about $451, or about $598 in cash — below the fair price — a good deal. Located in Windber, 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	$281 - $1,737	23%
Blue Cross Blue Shieldmajor	$150 - $2,288	12%
Aetnamajor	$191 - $1,147	16%
Cignamajor	$422 - $450	35%
Humanamajor	$443 - $1,147	36%
AmeriHealth	$237 - $1,147	19%
Geisinger	$241 - $1,923	20%
UPMC Health Plan	$264 - $1,641	22%
+ 2 smaller / regional plans	$270 - $1,166

Government programs also on file: Military & VA.

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 598), 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 Chan Soon- Shiong Medical Center at Windber 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 Chan Soon- Shiong Medical Center at Windber

Compare: Colonoscopy with biopsy at other PA hospitals

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