CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: St Lukes Regional Medical Center

Billing Code: 45378 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$614

about 0.6× the $950 Medicare rate · typically $456–$821

modeled estimate · not a bill or quote

What this hospital charges insurers

$427

Below the fair price — a good deal

about $187 under the fair price · 0.4× Medicare

Medicare pays $950 Fair price $614 This hospital $427 Cash price $814 Hospital's list price $1,017

How we calculate the fair BaseRate →

How this hospital compares to other IA hospitals

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

Cheapest $104 Priciest $427

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

A fair price for a Colonoscopy (diagnostic) is about $614 (about 0.6× the $950 Medicare rate). St Lukes Regional Medical Center charges insurers about $427, or about $814 in cash — below the fair price — a good deal. Located in Sioux City, IA.

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	$87 - $2,433	9%
Blue Cross Blue Shieldmajor	$84 - $906	9%
Aetnamajor	$83 - $2,229	9%
Cignamajor	$220 - $440	23%
Humanamajor	$87 - $933	9%
Amerigroup	$807	85%
HealthPartners	$167 - $1,361	18%
Molina	$84 - $906	9%
+ 4 smaller / regional plans	$87 - $2,252

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 814), 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 St Lukes Regional 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 St Lukes Regional Medical Center

Compare: Colonoscopy (diagnostic) at other IA hospitals

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