CMS Price Transparency Data

Colonoscopy with biopsy

Facility: De Tar Hospital Navarro

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,242

about 1.0× the $1,223 Medicare rate · typically $1,242–$1,563

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,242

About the fair price

1.0× Medicare

Medicare pays $1,223 Fair price $1,242 This hospital $1,242 Cash price $6,599 Hospital's list price $31,422

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 $1,242

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 $1,242 (about 1.0× the $1,223 Medicare rate). De Tar Hospital Navarro charges insurers about $1,242, or about $6,599 in cash — about the fair price. Located in Victoria, 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	$452 - $8,955	37%
Blue Cross Blue Shieldmajor	$461 - $6,567	38%
Aetnamajor	$1,218 - $17,910	100%
Cignamajor	$7,478 - $13,511	612%
Humanamajor	$1,183	97%
Amerigroup	$1,067 - $1,242	87%
+ 13 smaller / regional plans	$452 - $21,995

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

Excludes 5 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 6,599), 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 De Tar Hospital Navarro 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 De Tar Hospital Navarro

Compare: Colonoscopy with biopsy at other TX hospitals

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