CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Froedtert Memorial Lutheran Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,544

about 1.3× the $1,223 Medicare rate · typically $1,192–$3,446

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,198

Below the fair price — a good deal

about $346 under the fair price · 1.0× Medicare

Medicare pays $1,223 Fair price $1,544 This hospital $1,198

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

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

Cheapest $166 Priciest $1,198

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

A fair price for a Colonoscopy with biopsy is about $1,544 (about 1.3× the $1,223 Medicare rate). Froedtert Memorial Lutheran Hospital charges insurers about $1,198 — below the fair price — a good deal. Located in Milwaukee, WI.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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	$1,198 - $6,766	98%
Blue Cross Blue Shieldmajor	$1,198 - $5,761	98%
Aetnamajor	$1,222	100%
Humanamajor	$1,198	98%
Health Net	$4,714	386%
HealthPartners	$1,198	98%
Molina	$1,198	98%
Priority Health	$1,198	98%
Quartz	$1,198	98%
Security Health Plan	$1,198	98%
WellCare	$1,222	100%
+ 5 smaller / regional plans	$1,198 - $4,352

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, 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 Froedtert Memorial Lutheran 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 (%)

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Other Procedures at Froedtert Memorial Lutheran Hospital

Compare: Colonoscopy with biopsy at other WI hospitals

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