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Colposcopy with biopsy: what insurers pay

Magnified exam of the cervix with biopsy and endocervical sampling. Commercial negotiated rates by hospital and market, next to Medicare for the same code.

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CPT 57454: Colposcopy With Biopsy

1208 hospitals in 81 markets. National Medicare rate $311, surgery center $78.

MarketHospitals25th pctMedian75th pctLow–high
Alabama (statewide)13$282$350$754$214–$837
Alaska (statewide)5$486$719$1,929$275–$2,507
Arizona (statewide)6$667$1,213$1,833$210–$2,161
Arkansas (statewide)5$458$548$675$193–$931
Atlanta GA10$1,343$1,343$1,893$1,306–$1,893
Austin TX13$302$561$1,800$295–$1,800
Boston MA16$307$618$746$273–$1,283
California (statewide)57$446$898$1,151$233–$2,472
Charlotte NC6$362$362$362$357–$514
Chicago IL10$384$540$1,061$166–$1,356
Cleveland OH11$310$348$1,162$288–$2,035
Colorado (statewide)17$492$1,057$1,390$301–$2,182
Columbus OH2———$158–$1,096
Connecticut (statewide)3———$276–$1,270
Dallas-Fort Worth TX10$996$1,487$1,774$458–$2,048
Denver CO15$1,296$1,475$1,811$1,154–$2,444
Detroit MI16$244$284$342$169–$680
Florida (statewide)68$575$1,730$2,128$220–$2,428
Georgia (statewide)32$1,308$1,485$1,893$335–$2,087
Hawaii (statewide)4———$244–$688
Houston TX18$615$1,808$2,002$304–$2,052
Idaho (statewide)17$292$564$773$160–$2,056
Illinois (statewide)31$428$692$824$166–$1,166
Indiana (statewide)32$226$350$634$166–$1,941
Indianapolis IN4———$174–$226
Iowa (statewide)33$295$408$658$229–$1,203
Kansas (statewide)27$338$358$803$174–$1,300
Kentucky (statewide)15$406$1,062$1,614$330–$2,232
Las Vegas NV2———$1,588–$2,028
Los Angeles CA17$618$882$1,146$476–$1,528
Louisiana (statewide)14$317$384$482$264–$584
Maine (statewide)17$1,246$1,399$1,447$301–$1,819
Maryland (statewide)1———$403–$403
Massachusetts (statewide)7$312$333$435$312–$501
Miami-Fort Lauderdale FL3———$350–$568
Michigan (statewide)32$184$204$304$163–$497
Minneapolis-St. Paul MN9$619$946$1,140$324–$1,158
Minnesota (statewide)16$526$857$1,120$218–$1,839
Mississippi (statewide)12$285$334$554$178–$831
Missouri (statewide)14$269$356$622$192–$1,120
Montana (statewide)7$412$634$756$222–$953
Nashville TN8$502$798$1,028$408–$1,541
Nebraska (statewide)21$322$358$1,010$204–$2,028
Nevada (statewide)5$712$2,028$2,238$464–$2,238
New Hampshire (statewide)7$1,198$1,425$1,496$184–$1,983
New Jersey (statewide)26$354$610$1,269$337–$2,247
New Mexico (statewide)6$452$535$818$276–$1,852
New York (statewide)41$516$604$674$236–$1,570
New York City8$603$670$728$380–$1,156
North Carolina (statewide)5$542$755$755$336–$808
North Dakota (statewide)7$321$420$607$246–$733
Ohio (statewide)40$496$773$961$285–$1,556
Oklahoma (statewide)15$440$579$709$195–$1,374
Oregon (statewide)12$403$728$1,132$221–$1,427
Pennsylvania (statewide)28$388$554$856$316–$1,348
Philadelphia PA9$679$716$786$400–$1,034
Phoenix AZ8$1,448$1,602$1,885$1,448–$2,271
Pittsburgh PA7$391$396$475$286–$492
Portland OR9$1,068$1,068$1,212$874–$1,212
Rhode Island (statewide)4———$445–$1,440
Richmond VA3———$2,085–$2,123
Rio Grande Valley TX3———$389–$1,672
Salt Lake City UT9$347$402$402$274–$402
San Antonio TX3———$471–$1,913
San Diego CA7$666$666$670$554–$723
San Francisco Bay Area CA4———$484–$2,321
Seattle-Tacoma WA16$968$1,000$1,068$805–$1,128
South Carolina (statewide)30$664$1,082$1,315$222–$1,607
South Dakota (statewide)3———$399–$1,073
St. Louis MO3———$1,106–$1,199
Tampa FL6$1,400$1,400$1,400$972–$1,850
Tennessee (statewide)28$402$518$933$277–$1,541
Texas (statewide)70$442$934$1,398$210–$2,227
Utah (statewide)13$161$161$282$158–$402
Vermont (statewide)2———$210–$225
Virginia (statewide)16$1,027$1,660$1,731$411–$2,366
Washington (statewide)17$648$843$954$183–$1,584
Washington DC11$1,198$1,216$1,645$946–$2,098
West Virginia (statewide)9$509$513$990$338–$1,232
Wisconsin (statewide)40$568$1,204$1,810$150–$1,810
Wyoming (statewide)2———$305–$305

Lowest and highest 12 hospital medians

HospitalMarketMedian across insurers× MedicareInsurersFile date
Black River Memorial HospitalWisconsin (statewide)$1500.5×12026-01-08
Ohio State University HospitalsColumbus OH$1580.5×12026-07-01
San Juan HospitalUtah (statewide)$1580.5×52026-04-13
Intermountain Health Cassia Regional HospitalIdaho (statewide)$1600.5×22026-08-05
Intermountain Health Bear River Valley HospitalUtah (statewide)$1610.5×12026-08-05
Intermountain Health Sevier Valley HospitalUtah (statewide)$1610.5×12026-08-05
Intermountain Health Delta Community HospitalUtah (statewide)$1610.5×12026-07-28
Intermountain Health Fillmore Community HospitalUtah (statewide)$1610.5×12026-08-05
Intermountain Health Sanpete Valley HospitalUtah (statewide)$1610.5×12026-08-05
Intermountain Health Garfield Memorial HospitalUtah (statewide)$1610.5×12026-08-05
Mackinac Straits Hospital And Health CenterMichigan (statewide)$1630.5×12026-07-22
Advocate Illinois Masonic Medical CenterIllinois (statewide)$1660.5×12025-11-04
Hca Florida Jfk HospitalFlorida (statewide)$2,2427.0×82026-09-01
Hca Florida North Florida HospitalFlorida (statewide)$2,2427.0×52026-09-01
Jersey Shore University Medical CenterNew Jersey (statewide)$2,2476.5×12025-12-31
Hca Florida West HospitalFlorida (statewide)$2,2507.1×52026-09-01
Chandler Regional Medical Center (Dignity)Phoenix AZ$2,2717.0×22026-02-28
Mercy Gilbert Medical Center (Dignity)Phoenix AZ$2,2717.0×22026-02-28
Stanford Health Care Tri-ValleySan Francisco Bay Area CA$2,3215.4×22026-04-01
Lewisgale Medical CenterVirginia (statewide)$2,3668.0×12026-09-01
Hca Florida Highlands HospitalFlorida (statewide)$2,4287.6×32026-09-01
Denver Health Medical CenterDenver CO$2,4447.6×12026-04-30
Riverside Community HospitalCalifornia (statewide)$2,4726.3×42026-09-01
Providence Alaska Medical CenterAlaska (statewide)$2,5077.4×12026-04-01

Every hospital is on its state's page (linked in the market table) and in the interactive explorer.

Questions

How much do commercial insurers pay hospitals for colposcopy with biopsy?

Across 1208 hospitals in 81 markets (metro areas and statewide) that post a usable dollar rate, the median commercial rate for CPT 57454, hospital outpatient is $680, 2.1× the same hospital's local Medicare base rate. The middle half of hospitals runs $380 to $1,219. Figures are each hospital's median across insurers, from its federal price-transparency file.

What does Medicare pay for colposcopy with biopsy?

Medicare's national hospital outpatient rate for CPT 57454 is $311 and its surgery-center rate is $78, before local wage adjustment.

Which hospitals post the lowest and highest commercial rates for colposcopy with biopsy?

Lowest medians: Black River Memorial Hospital ($150), Ohio State University Hospitals ($158), San Juan Hospital ($158). Highest: Providence Alaska Medical Center ($2,507), Riverside Community Hospital ($2,472), Denver Health Medical Center ($2,444). Coverage: every hospital whose price file we could read.