CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Sisters of Charity Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $175
  • Cash Discount Price: $722
  • vs. Medicare Baseline: 0.18x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Sisters of Charity Hospital is $175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $722. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.18x the Medicare baseline. Located in 2157 Main Street, Buffalo, NY.
Cash / Self-Pay
$722

Average discount available for prompt cash payment at this facility.

Insurance Median
$175

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$950.1

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $950.1 (100%)
Cash / Self-Pay: $722 (76%)
Insurance Median: $175 (18%)
Cash: $722 (76% of Medicare)
Ins. Median: $175 (18% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $950.1 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicaid / KanCare $52 - $324 5%
Independent Health Essential [100166] $52 - $315 5%
Univera Healthcare [100169] $75 - $682 8%
Univera Healthcare Essential [100170] $75 - $281 8%
Beacon Essential [350122] $79 - $210 8%
Medicare (plans) $86 - $381 9%
Cigna $87 - $470 9%
Fallon Health [450115] $87 - $324 9%
Seneca Nation [450119] $87 - $324 9%
Catholic Health Life Pace [400005] $87 - $324 9%
Tricare $87 - $324 9%
Champ VA [700002] $87 - $324 9%
Hospice [550001] $87 - $324 9%
Covid19 Hrsa [45013] $87 - $324 9%
Fidelis Dual Advantage [450120] $92 - $341 10%
Wellcare Fidelis Dual [450451] $92 - $341 10%
Aetna $92 - $324 10%
Fidelis Essential [100163] $96 - $389 10%
Wellcare [450129] $96 - $357 10%
Ghi [100153] $96 - $357 10%
Crime Victims [100176] $103 - $315 11%
Amerigroup [350102] $103 - $315 11%
Vna Option Mltc [350110] $103 - $315 11%
Tuscarora Nation [550120] $103 - $315 11%
Excellus Rochester McD [350117] $103 - $315 11%
Blue Cross Blue Shield $103 - $575 11%
Fidelis Exchange [100164] $105 - $389 11%
Beacon Health Options [100023] $105 - $210 11%
Mvp Healthcare [100168] $115 - $404 12%
UnitedHealthcare $122 - $358 13%
UPMC Health Plan [100181] $157 - $449 17%
VA Veterans Affairs [700001] $157 - $324 17%
Iha First Choice [800001] $160 - $593 17%
Independent Health [100165] $160 - $593 17%
Meritain [100063] $162 - $324 17%
Magnacare [100142] $162 - $324 17%
Humana $183 - $324 19%
Molina Essential [100167] $232 - $708 24%
No Fault [114001] $709 75%
Federal Workers Compensation [500100] $709 75%
Workers Compensation [500101] $709 75%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2157 Main Street, Buffalo, NY 14214
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals