CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Texas Health Harris Methodist Hospital Southlake

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,309

about 1.1× the $1,223 Medicare rate · typically $1,013–$1,907

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,258

About the fair price

about $51 under the fair price · 1.0× Medicare

Medicare pays $1,223 Fair price $1,309 This hospital $1,258 Cash price $761 Hospital's list price $1,268

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 $1,258

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 $1,309 (about 1.1× the $1,223 Medicare rate). Texas Health Harris Methodist Hospital Southlake charges insurers about $1,258, or about $761 in cash — about the fair price. Located in Southlake, 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	$429 - $3,751	35%
Blue Cross Blue Shieldmajor	$429 - $8,391	35%
Aetnamajor	$472 - $889	39%
Cignamajor	$701 - $1,193	57%
Humanamajor	$1,252	102%
Amerigroup	$429 - $1,264	35%
Cigna HealthSpring	$1,228	100%
Molina	$464 - $1,264	38%
WellCare	$451 - $1,324	37%
+ 6 smaller / regional plans	$429 - $2,319

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 761), 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 Texas Health Harris Methodist Hospital Southlake 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 Texas Health Harris Methodist Hospital Southlake

Compare: Colonoscopy with biopsy at other TX hospitals

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