CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Wheeling Hospital, Inc

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,008

about 0.8× the $1,223 Medicare rate · typically $418–$1,150

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,152

About the fair price

about $144 over the fair price · 0.9× Medicare

Medicare pays $1,223 Fair price $1,008 This hospital $1,152 Cash price $1,791 Hospital's list price $3,581

How we calculate the fair BaseRate →

How this hospital compares to other WV hospitals

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

Cheapest $149 Priciest $1,152

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

A fair price for a Colonoscopy with biopsy is about $1,008 (about 0.8× the $1,223 Medicare rate). Wheeling Hospital, Inc charges insurers about $1,152, or about $1,791 in cash — about the fair price. Located in Wheeling, WV.

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	$1,255	103%
Blue Cross Blue Shieldmajor	$206 - $4,726	17%
Aetnamajor	$210 - $1,209	17%
Humanamajor	$1,209	99%
Geisinger	$225	18%
+ 4 smaller / regional plans	$209 - $1,209

Government programs also on file: Medicare, Medicaid.

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 1,791), 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 Wheeling Hospital, Inc 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 Wheeling Hospital, Inc

Compare: Colonoscopy with biopsy at other WV hospitals

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