CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: The Children's Mercy Hospital

Billing Code: 45378 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$400

about 0.4× the $950 Medicare rate · typically $241–$1,811

modeled estimate · not a bill or quote

What this hospital charges insurers

$247

Below the fair price — a good deal

about $153 under the fair price · 0.3× Medicare

Medicare pays $950 Fair price $400 This hospital $247 Cash price $392 Hospital's list price $817

How we calculate the fair BaseRate →

How this hospital compares to other MO hospitals

On the higher side — 7 of 8 other MO hospitals charge less.

Cheapest $158 Priciest $287

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

A fair price for a Colonoscopy (diagnostic) is about $400 (about 0.4× the $950 Medicare rate). The Children's Mercy Hospital charges insurers about $247, or about $392 in cash — below the fair price — a good deal. Located in Kansas City, MO.

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	$320 - $601	34%
Blue Cross Blue Shieldmajor	$104 - $643	11%
Aetnamajor	$104 - $132	11%
Cignamajor	$444	47%
Humanamajor	$118	12%
Health Net	$605	64%
HealthLink	$114	12%
Medica	$476	50%
+ 11 smaller / regional plans	$82 - $596

Government programs also on file: Medicaid.

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 392), 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 The Children's Mercy 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 The Children's Mercy Hospital

Compare: Colonoscopy (diagnostic) at other MO hospitals

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