CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Kenmore Mercy Hospital

Billing Code: 45378 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$291

about 0.3× the $950 Medicare rate · typically $156–$584

modeled estimate · not a bill or quote

What this hospital charges insurers

$175

Below the fair price — a good deal

about $116 under the fair price · 0.2× Medicare

Medicare pays $950 Fair price $291 This hospital $175 Cash price $722 Hospital's list price $722

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Lowest price of the 9 NY hospitals we have prices for — a strong deal.

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 $291 (about 0.3× the $950 Medicare rate). Kenmore Mercy Hospital charges insurers about $175, or about $722 in cash — below the fair price — a good deal. Located in Kenmore, 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 - $204	13%
Blue Cross Blue Shieldmajor	$103 - $315	11%
Aetnamajor	$92 - $183	10%
Cignamajor	$87 - $253	9%
Humanamajor	$183	19%
Amerigroup	$103	11%
Fidelis Care	$92 - $210	10%
Independent Health	$52 - $319	5%
Molina	$232	24%
MVP Health Care	$115 - $230	12%
UPMC Health Plan	$157 - $314	17%
WellCare	$92 - $192	10%
+ 16 smaller / regional plans	$75 - $709

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 1 rental-network / third-party entry (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 Kenmore Mercy 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 Kenmore Mercy Hospital

Compare: Colonoscopy (diagnostic) at other NY hospitals

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