CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Valleywise Health Medical Center

Billing Code: 45378 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$465

about 0.5× the $950 Medicare rate · typically $372–$933

modeled estimate · not a bill or quote

What this hospital charges insurers

$370

Below the fair price — a good deal

about $95 under the fair price · 0.4× Medicare

Medicare pays $950 Fair price $465 This hospital $370 Cash price $1,141 Hospital's list price $1,875

How we calculate the fair BaseRate →

How this hospital compares to other AZ hospitals

A typical price — 3 charge more and 5 charge less, among the 9 AZ hospitals compared.

Cheapest $167 Priciest $575

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Colonoscopy (diagnostic) is about $465 (about 0.5× the $950 Medicare rate). Valleywise Health Medical Center charges insurers about $370, or about $1,141 in cash — below the fair price — a good deal. Located in Phoenix, AZ.

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	$187 - $1,850	20%
Blue Cross Blue Shieldmajor	$162 - $2,764	17%
Aetnamajor	$106 - $1,956	11%
Cignamajor	$186 - $2,408	20%
Humanamajor	$304 - $992	32%
Banner Health	$162 - $992	17%
Devoted Health	$162 - $992	17%
Health Net	$137 - $1,898	14%
Molina	$174 - $1,092	18%
Oscar Health	$186 - $3,500	20%
+ 12 smaller / regional plans	$162 - $2,258

Government programs also on file: Military & VA.

Excludes 1 rental-network / third-party entry (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 1,141), 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: 45378.

Insurance Before you use insurance

Call your insurance company to confirm Valleywise Health Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 45378.
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 Valleywise Health Medical Center

Compare: Colonoscopy (diagnostic) at other AZ hospitals

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