CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Essentia Health

Billing Code: 45378 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$933

about 1.0× the $950 Medicare rate · typically $906–$968

modeled estimate · not a bill or quote

What this hospital charges insurers

$912

About the fair price

about $21 under the fair price · 1.0× Medicare

Medicare pays $950 Fair price $933 This hospital $912 Cash price $2,120 Hospital's list price $2,827

How we calculate the fair BaseRate →

How this hospital compares to other ND hospitals

A typical price — 4 charge more and 4 charge less, among the 9 ND hospitals compared.

Cheapest $249 Priciest $1,203

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

A fair price for a Colonoscopy (diagnostic) is about $933 (about 1.0× the $950 Medicare rate). Essentia Health charges insurers about $912, or about $2,120 in cash — about the fair price. Located in Fargo, ND.

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	$912 - $2,253	96%
Blue Cross Blue Shieldmajor	$912 - $2,088	96%
Aetnamajor	$2,403	253%
Cignamajor	$1,894	199%
HealthPartners	$912 - $1,894	96%
Medica	$758 - $1,792	80%
Sanford Health Plan	$1,212 - $1,614	128%
Security Health Plan	$912	96%
UCare	$912 - $1,860	96%
+ 11 smaller / regional plans	$881 - $2,177

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 2,120), 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 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

Compare: Colonoscopy (diagnostic) at other ND hospitals

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