CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Memorial Medical Center

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$396

about 0.3× the $1,223 Medicare rate · typically $257–$1,204

modeled estimate · not a bill or quote

What this hospital charges insurers

$442

About the fair price

about $46 over the fair price · 0.4× Medicare

Medicare pays $1,223 Fair price $396 This hospital $442 Cash price $701 Hospital's list price $1,001

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 $442

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 $396 (about 0.3× the $1,223 Medicare rate). Memorial Medical Center charges insurers about $442, or about $701 in cash — about the fair price. Located in Port Lavaca, 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	$174 - $1,332	14%
Blue Cross Blue Shieldmajor	$331 - $1,065	27%
Aetnamajor	$216 - $801	18%
Cignamajor	$360	29%
Humanamajor	$354 - $1,065	29%
Ambetter (Centene)	$141 - $426	12%
Amerigroup	$174 - $1,332	14%
Health Net	$360 - $801	29%
Healthcare Highways	$287 - $866	23%
Molina	$442 - $1,332	36%
+ 13 smaller / regional plans	$174 - $1,398

Government programs also on file: Military & VA.

Excludes 9 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 701), 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 Memorial 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 Memorial Medical Center

Compare: Colonoscopy with biopsy at other TX hospitals

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