CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Merit Health River Region

Billing Code: 45378 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$889

about 0.9× the $950 Medicare rate · typically $889–$894

modeled estimate · not a bill or quote

What this hospital charges insurers

$888

About the fair price

about $1 under the fair price · 0.9× Medicare

Medicare pays $950 Fair price $889 This hospital $888 Cash price $2,958 Hospital's list price $16,431

How we calculate the fair BaseRate →

How this hospital compares to other MS hospitals

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

Cheapest $155 Priciest $888

Black dot = this hospital, among the 9 MS 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 $889 (about 0.9× the $950 Medicare rate). Merit Health River Region charges insurers about $888, or about $2,958 in cash — about the fair price. Located in Vicksburg, MS.

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	$695 - $5,331	73%
Blue Cross Blue Shieldmajor	$527	55%
Aetnamajor	$896 - $6,572	94%
Cignamajor	$6,786 - $11,502	714%
Humanamajor	$2,506	264%
CareSource	$709	75%
Devoted Health	$888	93%
HealthPartners	$12,323	1297%
Molina	$750 - $1,319	79%
WellCare	$902	95%
+ 19 smaller / regional plans	$507 - $12,323

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 2,958), 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 Merit Health River Region 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 Merit Health River Region

Compare: Colonoscopy (diagnostic) at other MS hospitals

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