CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Carilion Medical Center

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,134

about 0.9× the $1,223 Medicare rate · typically $1,073–$2,011

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,073

About the fair price

about $61 under the fair price · 0.9× Medicare

Medicare pays $1,223 Fair price $1,134 This hospital $1,073 Cash price $1,463 Hospital's list price $4,179

How we calculate the fair BaseRate →

How this hospital compares to other VA hospitals

Lowest price of the 9 VA hospitals we have prices for — a strong deal.

Cheapest $1,073 Priciest $1,168

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

A fair price for a Colonoscopy with biopsy is about $1,134 (about 0.9× the $1,223 Medicare rate). Carilion Medical Center charges insurers about $1,073, or about $1,463 in cash — about the fair price. Located in Roanoke, VA.

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	$406 - $3,416	33%
Blue Cross Blue Shieldmajor	$388 - $4,356	32%
Aetnamajor	$406 - $2,775	33%
Cignamajor	$2,817 - $3,009	230%
Humanamajor	$406 - $1,140	33%
Sentara	$395 - $2,591	32%
+ 8 smaller / regional plans	$2,298 - $3,970

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 1,463), 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 Carilion 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 Carilion Medical Center

Compare: Colonoscopy with biopsy at other VA hospitals

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