CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Cleveland Clinic

Billing Code: 45378 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$802

about 0.8× the $950 Medicare rate · typically $399–$1,039

modeled estimate · not a bill or quote

What this hospital charges insurers

$600

Below the fair price — a good deal

about $202 under the fair price · 0.6× Medicare

Medicare pays $950 Fair price $802 This hospital $600 Cash price $2,445 Hospital's list price $3,762

How we calculate the fair BaseRate →

How this hospital compares to other OH hospitals

Highest price of the 9 OH hospitals we have prices for — worth calling around.

Cheapest $139 Priciest $600

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Colonoscopy (diagnostic) is about $802 (about 0.8× the $950 Medicare rate). Cleveland Clinic charges insurers about $600, or about $2,445 in cash — below the fair price — a good deal. Located in Cleveland, 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	$89 - $6,112	9%
Blue Cross Blue Shieldmajor	$173 - $3,195	18%
Aetnamajor	$173 - $4,016	18%
Cignamajor	$178 - $3,010	19%
Humanamajor	$173 - $3,198	18%
AmeriHealth	$103	11%
CareSource	$98 - $929	10%
Devoted Health	$173 - $845	18%
Molina	$103 - $976	11%
Oscar Health	$374 - $1,446	39%
Paramount	$96 - $957	10%
UniCare	$181 - $887	19%
UPMC Health Plan	$173 - $2,257	18%
+ 22 smaller / regional plans	$98 - $4,658

Excludes 5 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 2,445), 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 Cleveland Clinic 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 Cleveland Clinic

Compare: Colonoscopy (diagnostic) at other OH hospitals

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