CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Excela Health Westmoreland Regional Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,173

about 1.0× the $1,223 Medicare rate · typically $581–$1,241

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,230

About the fair price

about $57 over the fair price · 1.0× Medicare

Medicare pays $1,223 Fair price $1,173 This hospital $1,230 Cash price $1,500 Hospital's list price $2,500

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 $1,230

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 $1,173 (about 1.0× the $1,223 Medicare rate). Excela Health Westmoreland Regional Hospital charges insurers about $1,230, or about $1,500 in cash — about the fair price. Located in Greensburg, 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	$1,212 - $3,116	99%
Blue Cross Blue Shieldmajor	$394 - $2,572	32%
Aetnamajor	$1,201 - $2,681	98%
Cignamajor	$1,224 - $2,700	100%
Humanamajor	$1,212	99%
Ambetter (Centene)	$1,457	119%
AmeriHealth	$416 - $1,224	34%
Devoted Health	$1,224	100%
Geisinger	$384 - $1,224	31%
HealthPartners	$384 - $1,201	31%
UPMC Health Plan	$406 - $1,806	33%
+ 10 smaller / regional plans	$416 - $2,739

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 1,500), 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 Excela Health Westmoreland Regional 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 Excela Health Westmoreland Regional Hospital

Compare: Colonoscopy with biopsy at other PA hospitals

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