CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Sisters of Charity Hospital

Billing Code: 45378 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$210

about 0.2× the $950 Medicare rate · typically $123–$511

modeled estimate · not a bill or quote

What this hospital charges insurers

$232

About the fair price

about $22 over the fair price · 0.2× Medicare

Medicare pays $950 Fair price $210 This hospital $232 Cash price $722 Hospital's list price $722

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

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

Cheapest $175 Priciest $302

Black dot = this hospital, among the 9 NY 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 $210 (about 0.2× the $950 Medicare rate). Sisters of Charity Hospital charges insurers about $232, or about $722 in cash — about the fair price. Located in Buffalo, NY.

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	$122 - $358	13%
Blue Cross Blue Shieldmajor	$103 - $575	11%
Aetnamajor	$92 - $324	10%
Cignamajor	$87 - $470	9%
Humanamajor	$183 - $324	19%
Amerigroup	$103 - $315	11%
Fidelis Care	$92 - $389	10%
Independent Health	$52 - $593	5%
MagnaCare	$162 - $324	17%
Molina	$232 - $708	24%
MVP Health Care	$115 - $404	12%
UPMC Health Plan	$157 - $449	17%
WellCare	$92 - $357	10%
+ 16 smaller / regional plans	$75 - $709

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 722), 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 Sisters of Charity 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 Sisters of Charity Hospital

Compare: Colonoscopy (diagnostic) at other NY hospitals

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