CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Montefiore St Luke's Cornwall

Billing Code: 45378 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,200

about 1.3× the $950 Medicare rate · typically $964–$3,139

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,265

About the fair price

about $65 over the fair price · 1.3× Medicare

Medicare pays $950 Fair price $1,200 This hospital $1,265 Cash price $1,161

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 $1,265

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 $1,200 (about 1.3× the $950 Medicare rate). Montefiore St Luke's Cornwall charges insurers about $1,265, or about $1,161 in cash — about the fair price. Located in Newburgh, 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✓ Humana CignaKaiser 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	$1,161 - $4,457	122%
Blue Cross Blue Shieldmajor	$638 - $3,713	67%
Aetnamajor	$1,149 - $3,470	121%
Humanamajor	$1,277	134%
CDPHP	$1,161 - $2,811	122%
Fidelis Care	$1,161 - $1,347	122%
GEHA	$2,086 - $3,470	220%
MagnaCare	$810 - $3,000	85%
MVP Health Care	$1,647	173%
Oscar Health	$1,161 - $7,276	122%
WellCare	$1,196	126%
+ 13 smaller / regional plans	$530 - $9,638

Government programs also on file: Medicaid.

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 1,161), 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 Montefiore St Luke's Cornwall 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 Montefiore St Luke's Cornwall

Compare: Colonoscopy (diagnostic) at other NY hospitals

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