CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Adventist Health Lodi Memorial

Billing Code: 45378 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$888

about 0.9× the $950 Medicare rate · typically $291–$1,373

modeled estimate · not a bill or quote

What this hospital charges insurers

$368

Below the fair price — a good deal

about $520 under the fair price · 0.4× Medicare

Medicare pays $950 Fair price $888 This hospital $368 Cash price $41 Hospital's list price $588

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

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

Cheapest $148 Priciest $368

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 $888 (about 0.9× the $950 Medicare rate). Adventist Health Lodi Memorial charges insurers about $368, or about $41 in cash — below the fair price — a good deal. Located in Lodi, CA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 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	$164 - $4,954	17%
Blue Cross Blue Shieldmajor	$148 - $1,227	16%
Aetnamajor	$279 - $16,197	29%
Cignamajor	$216 - $1,354	23%
Humanamajor	$164 - $1,227	17%
Kaiser Permanentemajor	$187 - $1,227	20%
Bright Health	$2,453	258%
Health Net	$164 - $1,227	17%
+ 13 smaller / regional plans	$119 - $2,208

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

Excludes 5 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 41), 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 Lodi Memorial 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 Lodi Memorial

Compare: Colonoscopy (diagnostic) at other CA hospitals

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