CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Garnet Health Medical Center

Billing Code: 45378 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,677

about 1.8× the $950 Medicare rate · typically $985–$3,605

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,172

Below the fair price — a good deal

about $505 under the fair price · 1.2× Medicare

Medicare pays $950 Fair price $1,677 This hospital $1,172

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

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

Cheapest $175 Priciest $1,172

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

A fair price for a Colonoscopy (diagnostic) is about $1,677 (about 1.8× the $950 Medicare rate). Garnet Health Medical Center charges insurers about $1,172 — below the fair price — a good deal. Located in Middletown, NY.

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	$3,262	343%
Blue Cross Blue Shieldmajor	$2,764 - $3,490	291%
Aetnamajor	$405 - $2,969	43%
Cignamajor	$3,327	350%
CDPHP	$4,269	449%
Fidelis Care	$1,184	125%
Geisinger	$2,902	305%
MagnaCare	$255 - $811	27%
MVP Health Care	$461 - $926	49%
WellCare	$1,188	125%
+ 4 smaller / regional plans	$405 - $2,969

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, 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 Garnet Health Medical 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 Garnet Health Medical Center

Compare: Colonoscopy (diagnostic) at other NY hospitals

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