CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Palacios Community Medical Center

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$693

about 0.6× the $1,223 Medicare rate · typically $285–$1,388

modeled estimate · not a bill or quote

What this hospital charges insurers

$365

Below the fair price — a good deal

about $328 under the fair price · 0.3× Medicare

Medicare pays $1,223 Fair price $693 This hospital $365 Cash price $2,072 Hospital's list price $2,072

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

On the higher side — 7 of 8 other TX hospitals charge less.

Cheapest $174 Priciest $366

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 $693 (about 0.6× the $1,223 Medicare rate). Palacios Community Medical Center charges insurers about $365, or about $2,072 in cash — below the fair price — a good deal. Located in Palacios, TX.

What each insurance company pays

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

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

✓ Blue Cross Blue Shield✓ Aetna UnitedHealthcareCignaHumanaKaiser 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
Blue Cross Blue Shieldmajor	$336 - $753	27%
Aetnamajor	$543 - $2,183	44%
Molina	$336 - $1,653	27%
+ 1 smaller / regional plan	$336 - $365

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 2,072), 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 Palacios Community 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 Palacios Community Medical Center

Compare: Colonoscopy with biopsy at other TX hospitals

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