CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Mission Regional Medical Center

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,287

about 1.1× the $1,223 Medicare rate · typically $954–$1,785

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,268

About the fair price

about $19 under the fair price · 1.0× Medicare

Medicare pays $1,223 Fair price $1,287 This hospital $1,268 Cash price $1,196 Hospital's list price $8,165

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 $1,268

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

A fair price for a Colonoscopy with biopsy is about $1,287 (about 1.1× the $1,223 Medicare rate). Mission Regional Medical Center charges insurers about $1,268, or about $1,196 in cash — about the fair price. Located in Mission, TX.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$1,196	98%
Blue Cross Blue Shieldmajor	$1,196 - $1,446	98%
Aetnamajor	$1,196	98%
Cignamajor	$1,196 - $1,733	98%
Molina	$1,256 - $1,854	103%
WellMed	$1,196	98%
+ 7 smaller / regional plans	$1,196 - $2,392

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

Excludes 1 rental-network / third-party entry (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 1,196), 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 Mission Regional 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 (%)

Enter your details and press estimate to compare.

Other Procedures at Mission Regional Medical Center

Compare: Colonoscopy with biopsy at other TX hospitals

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