CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Mercy Hospital of Buffalo

Billing Code: 45378 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$208

about 0.2× the $950 Medicare rate · typically $116–$480

modeled estimate · not a bill or quote

What this hospital charges insurers

$275

Above the fair price

about $67 over the fair price · 0.3× Medicare

Medicare pays $950 Fair price $208 This hospital $275 Cash price $722 Hospital's list price $722

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

On the higher side — 6 of 8 other NY hospitals charge less.

Cheapest $175 Priciest $302

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 $208 (about 0.2× the $950 Medicare rate). Mercy Hospital of Buffalo charges insurers about $275, or about $722 in cash — above the fair price. Located in Buffalo, NY.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $208. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

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 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 Mercy Hospital of Buffalo 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 Hospital of Buffalo

Compare: Colonoscopy (diagnostic) at other NY hospitals

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