CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: South County Hospital Inc

Billing Code: 45378 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,461

about 1.5× the $950 Medicare rate · typically $940–$2,054

modeled estimate · not a bill or quote

What this hospital charges insurers

$965

Below the fair price — a good deal

about $496 under the fair price · 1.0× Medicare

Medicare pays $950 Fair price $1,461 This hospital $965 Cash price $3,102 Hospital's list price $5,171

How we calculate the fair BaseRate →

How this hospital compares to other RI hospitals

Lowest price of the 5 RI hospitals we have prices for — a strong deal.

Cheapest $965 Priciest $1,911

Black dot = this hospital, among the 5 RI 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 $1,461 (about 1.5× the $950 Medicare rate). South County Hospital Inc charges insurers about $965, or about $3,102 in cash — below the fair price — a good deal. Located in Wakefield, RI.

What each insurance company pays

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

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

✓ UnitedHealthcare Blue 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
UnitedHealthcaremajor	$959	101%
Tufts Health Plan	$924	97%
+ 1 smaller / regional plan	$3,214

Excludes 1 rental-network / third-party entry (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 3,102), 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 South County Hospital 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 South County Hospital Inc

Compare: Colonoscopy (diagnostic) at other RI hospitals

Landmark Medical Center · Woonsocket $1,040
Newport Hospital · Newport $1,861
Rhode Island Hospital · Providence $1,891
The Miriam Hospital · Providence $1,911

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