CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Essentia Health Ada

Billing Code: 45378 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$928

about 1.0× the $950 Medicare rate · typically $239–$1,673

modeled estimate · not a bill or quote

What this hospital charges insurers

$896

About the fair price

about $32 under the fair price · 0.9× Medicare

Medicare pays $950 Fair price $928 This hospital $896 Cash price $2,089 Hospital's list price $2,827

How we calculate the fair BaseRate →

How this hospital compares to other MN hospitals

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

Cheapest $156 Priciest $896

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

A fair price for a Colonoscopy (diagnostic) is about $928 (about 1.0× the $950 Medicare rate). Essentia Health Ada charges insurers about $896, or about $2,089 in cash — about the fair price. Located in Ada, MN.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$1,357 - $2,558	143%
Blue Cross Blue Shieldmajor	$1,357 - $2,464	143%
Aetnamajor	$2,403	253%
Cignamajor	$1,880	198%
HealthPartners	$1,100 - $1,880	116%
Medica	$1,125 - $2,547	118%
Sanford Health Plan	$1,212 - $1,276	128%
Security Health Plan	$1,357	143%
UCare	$1,357 - $1,860	143%
+ 12 smaller / regional plans	$881 - $2,464

Government programs also on file: Medicare.

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 2,089), 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 Essentia Health Ada 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 Essentia Health Ada

Compare: Colonoscopy (diagnostic) at other MN hospitals

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