CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Presence Saints Mary and Elizabeth Medical Center

Billing Code: 45378 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,016

about 1.1× the $950 Medicare rate · typically $932–$1,427

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,041

About the fair price

about $25 over the fair price · 1.1× Medicare

Medicare pays $950 Fair price $1,016 This hospital $1,041 Cash price $991 Hospital's list price $4,752

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

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

Cheapest $168 Priciest $1,041

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

A fair price for a Colonoscopy (diagnostic) is about $1,016 (about 1.1× the $950 Medicare rate). Presence Saints Mary and Elizabeth Medical Center charges insurers about $1,041, or about $991 in cash — about the fair price. Located in Chicago, IL.

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	$992 - $2,193	104%
Blue Cross Blue Shieldmajor	$942 - $1,388	99%
Aetnamajor	$992 - $2,571	104%
Cignamajor	$488 - $4,550	51%
Humanamajor	$992 - $1,238	104%
Ambetter (Centene)	$1,607	169%
Devoted Health	$992	104%
Health Net	$1,190	125%
HealthPartners	$992 - $1,140	104%
Meridian	$1,041 - $1,299	110%
Molina	$1,021 - $1,488	107%
WellCare	$992	104%
+ 11 smaller / regional plans	$183 - $1,537

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

Excludes 2 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 991), 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 Presence Saints Mary and Elizabeth 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 Presence Saints Mary and Elizabeth Medical Center

Compare: Colonoscopy (diagnostic) at other IL hospitals

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