CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Southern Ohio Medical Center

Billing Code: 45378 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$456

about 0.5× the $950 Medicare rate · typically $249–$788

modeled estimate · not a bill or quote

What this hospital charges insurers

$325

Below the fair price — a good deal

about $131 under the fair price · 0.3× Medicare

Medicare pays $950 Fair price $456 This hospital $325 Cash price $400 Hospital's list price $800

How we calculate the fair BaseRate →

How this hospital compares to other OH hospitals

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

Cheapest $139 Priciest $431

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

A fair price for a Colonoscopy (diagnostic) is about $456 (about 0.5× the $950 Medicare rate). Southern Ohio Medical Center charges insurers about $325, or about $400 in cash — below the fair price — a good deal. Located in Portsmouth, OH.

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	$98 - $704	10%
Blue Cross Blue Shieldmajor	$93 - $842	10%
Aetnamajor	$330 - $880	35%
Cignamajor	$300 - $664	32%
Humanamajor	$275 - $842	29%
Ambetter (Centene)	$173	18%
CareSource	$207 - $1,137	22%
Medical Mutual	$173 - $656	18%
Molina	$173 - $1,011	18%
WellCare	$173 - $328	18%
+ 6 smaller / regional plans	$173 - $1,179

Excludes 3 rental-network / third-party entries (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 400), 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 Southern Ohio 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 Southern Ohio Medical Center

Compare: Colonoscopy (diagnostic) at other OH hospitals

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