CMS Price Transparency Data

Colonoscopy with biopsy

Facility: St Marys Hospital Superior

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,296

about 1.1× the $1,223 Medicare rate · typically $401–$2,028

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,158

Below the fair price — a good deal

about $138 under the fair price · 0.9× Medicare

Medicare pays $1,223 Fair price $1,296 This hospital $1,158 Cash price $2,264 Hospital's list price $3,064

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 $1,158

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 $1,296 (about 1.1× the $1,223 Medicare rate). St Marys Hospital Superior charges insurers about $1,158, or about $2,264 in cash — below the fair price — a good deal. Located in Superior, 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✓ Cigna HumanaKaiser 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	$980 - $2,773	80%
Blue Cross Blue Shieldmajor	$980 - $2,461	80%
Aetnamajor	$2,604	213%
Cignamajor	$2,390	195%
HealthPartners	$980 - $2,390	80%
Medica	$980 - $2,463	80%
Sanford Health Plan	$1,314	107%
Security Health Plan	$980 - $2,359	80%
UCare	$980 - $2,016	80%
+ 13 smaller / regional plans	$980 - $2,635

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 2,264), 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 St Marys Hospital Superior 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 St Marys Hospital Superior

Compare: Colonoscopy with biopsy at other WI hospitals

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