CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Smyth County Community Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,322

about 1.1× the $1,223 Medicare rate · typically $1,198–$1,832

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,248

About the fair price

about $74 under the fair price · 1.0× Medicare

Medicare pays $1,223 Fair price $1,322 This hospital $1,248 Cash price $484 Hospital's list price $3,227

How we calculate the fair BaseRate →

How this hospital compares to other VA hospitals

Highest price of the 9 VA hospitals we have prices for — worth calling around.

Cheapest $1,073 Priciest $1,248

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 $1,322 (about 1.1× the $1,223 Medicare rate). Smyth County Community Hospital charges insurers about $1,248, or about $484 in cash — about the fair price. Located in Marion, 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	$1,107 - $2,397	91%
Blue Cross Blue Shieldmajor	$948 - $3,227	78%
Aetnamajor	$1,168 - $2,743	96%
Cignamajor	$1,226 - $1,956	100%
Humanamajor	$1,168	96%
Ambetter (Centene)	$2,545	208%
Amerigroup	$1,168 - $3,227	96%
Devoted Health	$1,226	100%
Molina	$1,214 - $1,321	99%
Sentara	$898 - $1,270	73%
+ 3 smaller / regional plans	$1,168 - $3,227

Government programs also on file: Medicare.

Excludes 2 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 484), 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 Smyth County Community Hospital 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 Smyth County Community Hospital

Compare: Colonoscopy with biopsy at other VA hospitals

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