CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Sarah Bush Lincoln Health Center

Billing Code: 45378 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$291

about 0.3× the $950 Medicare rate · typically $151–$825

modeled estimate · not a bill or quote

What this hospital charges insurers

$172

Below the fair price — a good deal

about $119 under the fair price · 0.2× Medicare

Medicare pays $950 Fair price $291 This hospital $172 Cash price $839 Hospital's list price $839

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

One of the lower prices — 6 of 8 other IL hospitals charge more for the same procedure.

Cheapest $168 Priciest $217

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Colonoscopy (diagnostic) is about $291 (about 0.3× the $950 Medicare rate). Sarah Bush Lincoln Health Center charges insurers about $172, or about $839 in cash — below the fair price — a good deal. Located in Mattoon, 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	$168 - $1,161	18%
Blue Cross Blue Shieldmajor	$327 - $701	34%
Aetnamajor	$168 - $1,259	18%
Cignamajor	$250 - $1,259	26%
Humanamajor	$168 - $172	18%
HealthLink	$239 - $1,203	25%
Meridian	$168	18%
Molina	$168 - $419	18%
WellCare	$168	18%
+ 17 smaller / regional plans	$111 - $1,259

Government programs also on file: Military & VA.

Excludes 6 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 839), 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 Sarah Bush Lincoln Health 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 Sarah Bush Lincoln Health Center

Compare: Colonoscopy (diagnostic) at other IL hospitals

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