Colonoscopy (diagnostic)
Facility: Mount Carmel East & West
Billing Code: 45378 (CPT)
This hospital's typical commercial price is $3,262 compared to the $1,396 fair price benchmark.
2-Star CMS clinical quality rating paired with 2.34× fair market pricing.
Highest price of the 9 OH hospitals we have prices for — worth calling around.
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 $1,396 (about 1.5× the $950 Medicare rate). Mount Carmel East & West charges insurers about $3,262, or about $3,030 in cash — well above the fair price. Located in Columbus, OH.
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 $1,396. 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.
4 of 6 major insurers have a published price at this hospital
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 | $879 - $6,061 | 93% |
| Blue Cross Blue Shieldmajor | $862 - $3,345 | 91% |
| Aetnamajor | $862 - $3,698 | 91% |
| Cignamajor | $3,262 | 343% |
| GEHA | $6,061 | 638% |
| HealthPartners | $3,262 | 343% |
| Medical Mutual | $2,203 - $3,060 | 232% |
| MVP Health Care | $3,262 | 343% |
| Oscar Health | $1,452 | 153% |
| Priority Health | $3,262 | 343% |
| + 13 smaller / regional plans | $632 - $3,698 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at Mount Carmel East & West
Compare: Colonoscopy (diagnostic) at other OH hospitals
- Cincinnati Children's Hospital Medical Center · Cincinnati $139
- Genesis Hospital · Zanesville $162
- Southwest General Health Center · Middleburg Heights $171
- Ashtabula County Medical Center · Ashtabula $210
- Fisher-Titus Hospital · Norwalk $242
- Akron Children's Hospital · Akron $348
- Henry County Hospital, Inc · Napoleon $431
- Union Hospital · Dover $443
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Mount Carmel East & West (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $2,842
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $2,842).
Self-Pay Cash Rate ($3,030) Beats Your Bill
Mount Carmel East & West's published 45 CFR § 180 self-pay cash rate is $3,030 (vs. $3,262 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $1,396 Fair BaseRate ($950 Medicare)
Your bill ($7,829) is $6,433 above the denoised Fair BaseRate ($1,396) and 8.2× the $950 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.