CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Phelps Memorial Health Center

Billing Code: 45378 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$249

about 0.3× the $950 Medicare rate · typically $165–$1,420

modeled estimate · not a bill or quote

What this hospital charges insurers

$275

About the fair price

about $26 over the fair price · 0.3× Medicare

Medicare pays $950 Fair price $249 This hospital $275 Cash price $1,433 Hospital's list price $1,592

How we calculate the fair BaseRate →

How this hospital compares to other NE hospitals

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

Cheapest $144 Priciest $275

Black dot = this hospital, among the 9 NE 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 $249 (about 0.3× the $950 Medicare rate). Phelps Memorial Health Center charges insurers about $275, or about $1,433 in cash — about the fair price. Located in Holdrege, NE.

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	$153 - $3,531	16%
Blue Cross Blue Shieldmajor	$153 - $3,458	16%
Aetnamajor	$360 - $3,356	38%
Ambetter (Centene)	$278 - $4,070	29%
HealthPartners	$3,458	364%
Medica	$153 - $3,422	16%
Molina	$854 - $1,602	90%
WellCare	$153 - $1,565	16%
+ 7 smaller / regional plans	$153 - $3,458

Government programs also on file: 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 1,433), 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 Phelps Memorial Health Center 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 Phelps Memorial Health Center

Compare: Colonoscopy (diagnostic) at other NE hospitals

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