CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Mercy Medical Center

Billing Code: 45378 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,102

about 1.2× the $950 Medicare rate · typically $442–$1,386

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,095

About the fair price

about $7 under the fair price · 1.2× Medicare

Medicare pays $950 Fair price $1,102 This hospital $1,095

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 $1,095

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 $1,102 (about 1.2× the $950 Medicare rate). Mercy Medical Center charges insurers about $1,095 — about the fair price. Located in Rockville Centre, 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	$1,004 - $4,122	106%
Blue Cross Blue Shieldmajor	$1,057 - $4,122	111%
Aetnamajor	$1,079 - $4,264	114%
Cignamajor	$2,656	280%
Humanamajor	$1,100	116%
AmeriHealth	$3,902	411%
Cigna HealthSpring	$1,079	114%
Fidelis Care	$1,004 - $2,259	106%
Independent Health	$1,004 - $1,079	106%
MVP Health Care	$1,004 - $2,656	106%
WellCare	$1,187	125%
+ 33 smaller / regional plans	$389 - $4,264

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, 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 Mercy 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 Mercy Medical Center

Compare: Colonoscopy (diagnostic) at other NY hospitals

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