Colonoscopy (diagnostic)
Facility: Landmark Medical Center
Billing Code: 45378 (CPT)
This hospital's typical commercial price is $1,040 compared to the $1,086 fair price benchmark.
2-Star CMS clinical quality rating paired with 0.96× fair market pricing.
A typical price — 3 charge more and 2 charge less, among the 6 RI hospitals compared.
Black dot = this hospital, among the 6 RI hospitals with a price for this procedure. Full list below.
A fair price for a Colonoscopy (diagnostic) is about $1,086 (about 1.1× the $950 Medicare rate). Landmark Medical Center charges insurers about $1,040, or about $1,040 in cash — about the fair price. Located in Woonsocket, RI.
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
4 of 6 major insurers have a published price at this hospital
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 | $1,040 - $5,510 | 109% |
| Blue Cross Blue Shieldmajor | $958 - $1,471 | 101% |
| Aetnamajor | $1,040 | 109% |
| Humanamajor | $1,040 | 109% |
| Tufts Health Plan | $520 - $1,040 | 55% |
| WellCare | $1,061 | 112% |
| + 3 smaller / regional plans | $925 - $1,900 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at Landmark Medical Center
Compare: Colonoscopy (diagnostic) at other RI hospitals
- Westerly Hospital · Westerly $688
- South County Hospital Inc · Wakefield $965
- 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.
Audit a Bill or Quote at Landmark Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $1,875
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $1,875).
Self-Pay Cash Rate ($1,040) Beats Your Bill
Landmark Medical Center's published 45 CFR § 180 self-pay cash rate is $1,040 (vs. $1,040 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $1,086 Fair BaseRate ($950 Medicare)
Your bill ($5,166) is $4,080 above the denoised Fair BaseRate ($1,086) and 5.4× the $950 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.