CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Lafollette Medical Center

Billing Code: 45378 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$923

about 1.0× the $950 Medicare rate · typically $890–$941

modeled estimate · not a bill or quote

What this hospital charges insurers

$934

About the fair price

about $11 over the fair price · 1.0× Medicare

Medicare pays $950 Fair price $923 This hospital $934 Cash price $3,866 Hospital's list price $14,318

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

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

Cheapest $166 Priciest $934

Black dot = this hospital, among the 9 TN 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 $923 (about 1.0× the $950 Medicare rate). Lafollette Medical Center charges insurers about $934, or about $3,866 in cash — about the fair price. Located in La Follette, TN.

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	$743 - $14,318	78%
Blue Cross Blue Shieldmajor	$889 - $2,546	94%
Aetnamajor	$916 - $8,906	96%
Cignamajor	$3,201	337%
Humanamajor	$889 - $3,150	94%
Ambetter (Centene)	$1,672	176%
Amerigroup	$552 - $934	58%
Cigna HealthSpring	$916	96%
Devoted Health	$907	95%
WellCare	$904 - $3,580	95%
+ 9 smaller / regional plans	$718 - $1,988

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

Excludes 4 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 3,866), 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 Lafollette 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.

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 Lafollette Medical Center

Compare: Colonoscopy (diagnostic) at other TN hospitals

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