CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Clearwater Valley Hospital & Clinics

Billing Code: 45378 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$280

about 0.3× the $950 Medicare rate · typically $163–$1,266

modeled estimate · not a bill or quote

What this hospital charges insurers

$158

Below the fair price — a good deal

about $122 under the fair price · 0.2× Medicare

Medicare pays $950 Fair price $280 This hospital $158 Cash price $335 Hospital's list price $446

How we calculate the fair BaseRate →

How this hospital compares to other ID hospitals

A typical price — 4 charge more and 4 charge less, among the 9 ID hospitals compared.

Cheapest $91 Priciest $381

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

A fair price for a Colonoscopy (diagnostic) is about $280 (about 0.3× the $950 Medicare rate). Clearwater Valley Hospital & Clinics charges insurers about $158, or about $335 in cash — below the fair price — a good deal. Located in Orofino, ID.

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	$376	40%
Blue Cross Blue Shieldmajor	$142 - $260	15%
Aetnamajor	$246	26%
Cignamajor	$345	36%
Humanamajor	$154 - $263	16%
GEHA	$433	46%
+ 5 smaller / regional plans	$154 - $437

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 335), 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 Clearwater Valley Hospital & Clinics 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 Clearwater Valley Hospital & Clinics

Compare: Colonoscopy (diagnostic) at other ID hospitals

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