CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Franklin Woods Community Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,155

about 0.9× the $1,223 Medicare rate · typically $1,125–$1,226

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,141

About the fair price

about $14 under the fair price · 0.9× Medicare

Medicare pays $1,223 Fair price $1,155 This hospital $1,141 Cash price $484 Hospital's list price $3,227

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

Highest price of the 9 TN hospitals we have prices for — worth calling around.

Cheapest $258 Priciest $1,141

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 $1,155 (about 0.9× the $1,223 Medicare rate). Franklin Woods Community Hospital charges insurers about $1,141, or about $484 in cash — about the fair price. Located in Johnson City, 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	$1,086 - $2,397	89%
Blue Cross Blue Shieldmajor	$939 - $2,521	77%
Aetnamajor	$1,086 - $2,059	89%
Cignamajor	$1,141 - $1,956	93%
Humanamajor	$1,086	89%
Ambetter (Centene)	$2,369	194%
Amerigroup	$782 - $1,086	64%
Devoted Health	$1,141	93%
Molina	$1,130 - $1,430	92%
Sentara	$935 - $1,375	76%
WellCare	$1,152 - $3,227	94%
+ 3 smaller / regional plans	$1,086 - $3,227

Government programs also on file: Medicare.

Excludes 2 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 484), 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 Franklin Woods Community 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 Franklin Woods Community Hospital

Compare: Colonoscopy with biopsy at other TN hospitals

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