CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Mercy Hospital Ardmore, Inc

Billing Code: 45378 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$930

about 1.0× the $950 Medicare rate · typically $757–$1,269

modeled estimate · not a bill or quote

What this hospital charges insurers

$911

About the fair price

about $19 under the fair price · 1.0× Medicare

Medicare pays $950 Fair price $930 This hospital $911 Cash price $1,534 Hospital's list price $2,360

How we calculate the fair BaseRate →

How this hospital compares to other OK hospitals

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

Cheapest $159 Priciest $911

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

A fair price for a Colonoscopy (diagnostic) is about $930 (about 1.0× the $950 Medicare rate). Mercy Hospital Ardmore, Inc charges insurers about $911, or about $1,534 in cash — about the fair price. Located in Ardmore, OK.

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	$491 - $929	52%
Blue Cross Blue Shieldmajor	$170 - $912	18%
Aetnamajor	$557 - $911	59%
Cignamajor	$771 - $3,261	81%
Humanamajor	$875 - $929	92%
Ambetter (Centene)	$380 - $1,254	40%
Healthcare Highways	$761	80%
HealthLink	$761 - $824	80%
Independent Health	$911	96%
Medica	$486 - $1,268	51%
+ 38 smaller / regional plans	$127 - $2,050

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 8 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 1,534), 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 Ardmore, Inc 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 Ardmore, Inc

Compare: Colonoscopy (diagnostic) at other OK hospitals

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