CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Adventist Health Sonora

Billing Code: 45378 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$227

about 0.2× the $950 Medicare rate · typically $174–$991

modeled estimate · not a bill or quote

What this hospital charges insurers

$164

Below the fair price — a good deal

about $63 under the fair price · 0.2× Medicare

Medicare pays $950 Fair price $227 This hospital $164 Cash price $106 Hospital's list price $623

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

One of the lower prices — 7 of 8 other CA hospitals charge more for the same procedure.

Cheapest $148 Priciest $215

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

A fair price for a Colonoscopy (diagnostic) is about $227 (about 0.2× the $950 Medicare rate). Adventist Health Sonora charges insurers about $164, or about $106 in cash — below the fair price — a good deal. Located in Sonora, CA.

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	$164 - $537	17%
Blue Cross Blue Shieldmajor	$164 - $623	17%
Aetnamajor	$354	37%
Cignamajor	$202	21%
Health Net	$50 - $240	5%
+ 11 smaller / regional plans	$50 - $758

Government programs also on file: Medicaid, Military & VA.

Excludes 3 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 106), 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 Adventist Health Sonora 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 Adventist Health Sonora

Compare: Colonoscopy (diagnostic) at other CA hospitals

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