Colonoscopy (diagnostic)
Facility: Emory University Hospital Midtown
Billing Code: 45378 (CPT)
This hospital's typical commercial price is $3,051 compared to the $1,613 fair price benchmark.
2-Star CMS clinical quality rating paired with 1.89× fair market pricing.
Highest price of the 9 GA hospitals we have prices for — worth calling around.
Black dot = this hospital, among the 9 GA hospitals with a price for this procedure. Full list below.
A fair price for a Colonoscopy (diagnostic) is about $1,613 (about 1.7× the $950 Medicare rate). Emory University Hospital Midtown charges insurers about $3,051, or about $3,650 in cash — well above the fair price. Located in Atlanta, GA.
This price is above the fair BaseRate — you may be able to pay less
Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $1,613. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.
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
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 | $2,912 - $3,425 | 306% |
| Blue Cross Blue Shieldmajor | $954 - $4,221 | 100% |
| Aetnamajor | $963 - $3,826 | 101% |
| Cignamajor | $973 - $4,797 | 102% |
| Humanamajor | $5,346 | 563% |
| Kaiser Permanentemajor | $3,051 | 321% |
| Ambetter (Centene) | $2,002 | 211% |
| Clover Health | $992 | 104% |
| Devoted Health | $945 | 99% |
| Oscar Health | $4,249 | 447% |
| WellCare | $1,001 | 105% |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at Emory University Hospital Midtown
Compare: Colonoscopy (diagnostic) at other GA hospitals
- Atrium Health Navicent Peach · Byron $200
- Navicent Health Baldwin · Milledgeville $207
- Miller County Hospital · Colquitt $219
- Jeff Davis Hospital · Hazlehurst $271
- Shepherd Center, Inc. · Atlanta $381
- Northside Hospital Forsyth · Cumming $547
- Northside Hospital Cherokee · Canton $547
- Northside Hospital · Atlanta $547
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Emory University Hospital Midtown (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $1,325
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $1,325).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Emory University Hospital Midtown's published 45 CFR § 180 self-pay cash rate is $3,650 (vs. $3,051 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $1,613 Fair BaseRate ($950 Medicare)
Your bill ($3,650) is $2,037 above the denoised Fair BaseRate ($1,613) and 3.8× the $950 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.