CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Erlanger Medical Center

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$504

about 0.4× the $1,223 Medicare rate · typically $448–$1,406

modeled estimate · not a bill or quote

What this hospital charges insurers

$491

About the fair price

about $13 under the fair price · 0.4× Medicare

Medicare pays $1,223 Fair price $504 This hospital $491 Cash price $475 Hospital's list price $899

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

A typical price — 5 charge more and 3 charge less, among the 9 TN hospitals compared.

Cheapest $258 Priciest $1,100

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

A fair price for a Colonoscopy with biopsy is about $504 (about 0.4× the $1,223 Medicare rate). Erlanger Medical Center charges insurers about $491, or about $475 in cash — about the fair price. Located in Chattanooga, TN.

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	$186 - $2,871	15%
Blue Cross Blue Shieldmajor	$260 - $1,901	21%
Aetnamajor	$262 - $1,114	21%
Cignamajor	$249 - $1,082	20%
Humanamajor	$260 - $1,082	21%
Ambetter (Centene)	$326 - $1,352	27%
Amerigroup	$234 - $555	19%
CareSource	$316 - $2,163	26%
Clover Health	$260 - $1,082	21%
Devoted Health	$271 - $1,125	22%
UPMC Health Plan	$260 - $1,082	21%
+ 13 smaller / regional plans	$260 - $2,704

Government programs also on file: Medicare, Medicaid.

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 475), 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 Erlanger Medical Center 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 Erlanger Medical Center

Compare: Colonoscopy with biopsy at other TN hospitals

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