CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Breckinridge Memorial Hospital

Billing Code: 45378 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$357

about 0.4× the $950 Medicare rate · typically $149–$1,295

modeled estimate · not a bill or quote

What this hospital charges insurers

$159

Below the fair price — a good deal

about $198 under the fair price · 0.2× Medicare

Medicare pays $950 Fair price $357 This hospital $159 Cash price $448 Hospital's list price $895

How we calculate the fair BaseRate →

How this hospital compares to other KY hospitals

Lowest price of the 9 KY hospitals we have prices for — a strong deal.

Cheapest $159 Priciest $309

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

A fair price for a Colonoscopy (diagnostic) is about $357 (about 0.4× the $950 Medicare rate). Breckinridge Memorial Hospital charges insurers about $159, or about $448 in cash — below the fair price — a good deal. Located in Hardinsburg, KY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser 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	$159	17%
Blue Cross Blue Shieldmajor	$159 - $895	17%
Aetnamajor	$159 - $895	17%
Ambetter (Centene)	$159	17%
CareSource	$159	17%
Molina	$159	17%
WellCare	$159 - $895	17%
+ 1 smaller / regional plan	$159

Government programs also on file: Military & VA.

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 448), 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 Breckinridge Memorial Hospital 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 Breckinridge Memorial Hospital

Compare: Colonoscopy (diagnostic) at other KY hospitals

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