CMS Price Transparency Data

Colonoscopy with biopsy

Facility: UT of Texas Southwestern University Hospital - William P. Clements Jr.

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,219

about 1.0× the $1,223 Medicare rate · typically $551–$1,763

modeled estimate · not a bill or quote

What this hospital charges insurers

$473

Below the fair price — a good deal

about $746 under the fair price · 0.4× Medicare

Medicare pays $1,223 Fair price $1,219 This hospital $473 Cash price $2,969 Hospital's list price $5,938

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

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

Cheapest $174 Priciest $473

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Colonoscopy with biopsy is about $1,219 (about 1.0× the $1,223 Medicare rate). UT of Texas Southwestern University Hospital - William P. Clements Jr. charges insurers about $473, or about $2,969 in cash — below the fair price — a good deal. Located in Dallas, TX.

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	$158 - $6,261	13%
Blue Cross Blue Shieldmajor	$158 - $4,437	13%
Aetnamajor	$182 - $4,151	15%
Cignamajor	$818 - $4,373	67%
Humanamajor	$202 - $1,226	17%
Ambetter (Centene)	$197	16%
Molina	$158 - $1,238	13%
+ 7 smaller / regional plans	$158 - $4,157

Excludes 4 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 2,969), 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 UT of Texas Southwestern University Hospital - William P. Clements Jr. 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 UT of Texas Southwestern University Hospital - William P. Clements Jr.

Compare: Colonoscopy with biopsy at other TX hospitals

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