CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: UPMC Bedford Memorial

Billing Code: 45378 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$924

about 1.0× the $950 Medicare rate · typically $474–$1,078

modeled estimate · not a bill or quote

What this hospital charges insurers

$809

Below the fair price — a good deal

about $115 under the fair price · 0.9× Medicare

Medicare pays $950 Fair price $924 This hospital $809 Cash price $1,500 Hospital's list price $2,500

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 $809

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 $924 (about 1.0× the $950 Medicare rate). UPMC Bedford Memorial charges insurers about $809, or about $1,500 in cash — below the fair price — a good deal. Located in Everett, PA.

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	$190 - $1,675	20%
Blue Cross Blue Shieldmajor	$268 - $2,493	28%
Aetnamajor	$226 - $1,675	24%
Cignamajor	$939 - $1,675	99%
Humanamajor	$2,250	237%
AmeriHealth	$282 - $939	30%
Geisinger	$251	26%
HealthPartners	$272	29%
UPMC Health Plan	$199 - $2,316	21%
+ 5 smaller / regional plans	$308 - $2,250

Excludes 2 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 1,500), 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 UPMC Bedford Memorial 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 UPMC Bedford Memorial

Compare: Colonoscopy (diagnostic) at other PA hospitals

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