CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Caribbean Medical Center

Billing Code: 45378 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$188

about 0.2× the $950 Medicare rate · typically $117–$599

modeled estimate · not a bill or quote

Medicare pays $950 Fair price $188 Hospital's list price $100

How we calculate the fair BaseRate →

What each insurance company pays

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

0 of 6 major insurers have a published price at this hospital

UnitedHealthcareBlue Cross Blue ShieldAetnaCignaHumanaKaiser 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
No insurance-company prices are published for this procedure.
+ 7 smaller / regional plans	$100 - $728

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, 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 Caribbean Medical Center 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.

Other Procedures at Caribbean Medical Center

Compare: Colonoscopy (diagnostic) at other PR hospitals

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