CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 45378 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,032

about 1.1× the $950 Medicare rate · typically $427–$1,469

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,036

About the fair price

about $4 over the fair price · 1.1× Medicare

Medicare pays $950 Fair price $1,032 This hospital $1,036 Cash price $2,673 Hospital's list price $2,673

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

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

Cheapest $90 Priciest $1,036

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

A fair price for a Colonoscopy (diagnostic) is about $1,032 (about 1.1× the $950 Medicare rate). Hospital of Univ of Pennsylvania charges insurers about $1,036, or about $2,673 in cash — about the fair price. Located in Philadelphia, PA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 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	$169 - $4,927	18%
Blue Cross Blue Shieldmajor	$113 - $20,526	12%
Aetnamajor	$95 - $4,927	10%
Cignamajor	$145 - $4,326	15%
Humanamajor	$334 - $3,942	35%
Kaiser Permanentemajor	$190 - $4,927	20%
Clover Health	$1,056	111%
Devoted Health	$1,026	108%
Geisinger	$1,007 - $3,100	106%
Health Net	$251 - $2,956	26%
HealthPartners	$108 - $4,927	11%
Oscar Health	$1,662	175%
UPMC Health Plan	$307 - $4,927	32%
+ 39 smaller / regional plans	$71 - $4,927

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

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 2,673), 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 Hospital of Univ of Pennsylvania 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 Hospital of Univ of Pennsylvania

Compare: Colonoscopy (diagnostic) at other PA hospitals

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