CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Surgical Institute of Reading

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,464

about 1.2× the $1,223 Medicare rate · typically $270–$1,726

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,712

Above the fair price

about $248 over the fair price · 1.4× Medicare

Medicare pays $1,223 Fair price $1,464 This hospital $1,712 Cash price $1,726 Hospital's list price $5,205

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 $1,712

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 $1,464 (about 1.2× the $1,223 Medicare rate). Surgical Institute of Reading charges insurers about $1,712, or about $1,726 in cash — above the fair price. Located in Wyomissing, PA.

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 $1,464. 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.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$2,728	223%
Blue Cross Blue Shieldmajor	$463 - $1,712	38%
Aetnamajor	$1,124 - $4,320	92%
Cignamajor	$243,594	19925%
Geisinger	$1,124 - $1,687	92%
+ 2 smaller / regional plans	$225 - $3,123

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 1,726), 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 Surgical Institute of Reading 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.

Compare: Colonoscopy with biopsy at other PA hospitals

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

This price is above the fair BaseRate — you may be able to pay less

What each insurance company pays

Self-Pay How to get the cash price

Insurance Before you use insurance

Other Procedures at Surgical Institute of Reading

Compare: Colonoscopy with biopsy at other PA hospitals