CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Prisma Health Richland Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,085

about 0.9× the $1,223 Medicare rate · typically $1,085–$1,520

modeled estimate · not a bill or quote

What this hospital charges insurers

$833

Below the fair price — a good deal

about $252 under the fair price · 0.7× Medicare

Medicare pays $1,223 Fair price $1,085 This hospital $833 Cash price $2,439 Hospital's list price $3,752

How we calculate the fair BaseRate →

How this hospital compares to other SC hospitals

A typical price — 4 charge more and 4 charge less, among the 9 SC hospitals compared.

Cheapest $258 Priciest $1,113

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

A fair price for a Colonoscopy with biopsy is about $1,085 (about 0.9× the $1,223 Medicare rate). Prisma Health Richland Hospital charges insurers about $833, or about $2,439 in cash — below the fair price — a good deal. Located in Columbia, SC.

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	$459 - $7,650	38%
Blue Cross Blue Shieldmajor	$459 - $2,072	38%
Aetnamajor	$459 - $2,964	38%
Cignamajor	$459 - $2,604	38%
Humanamajor	$459 - $2,814	38%
Ambetter (Centene)	$845 - $2,112	69%
Molina	$459 - $1,205	38%
WellCare	$459 - $1,205	38%
+ 18 smaller / regional plans	$459 - $7,650

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 6 rental-network / third-party entries (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 2,439), 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 Prisma Health Richland 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 (%)

Enter your details and press estimate to compare.

Other Procedures at Prisma Health Richland Hospital

Compare: Colonoscopy with biopsy at other SC hospitals

Cannon Memorial Hospital · Pickens $258
Anmed Health · Anderson $317
Conway Medical Center · Conway $387
Aiken Regional Medical Center · Aiken $822
Piedmont Medical Center · Rock Hill $892
Prisma Health Greer Memorial Hospital · Spartanburg $1,071
MUSC Medical Center · Charleston $1,113
MUSC Health Marion Medical Center · Mullins $1,113

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