CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Saint Thomas Highlands Hospital

Billing Code: 45378 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$901

about 0.9× the $950 Medicare rate · typically $853–$1,119

modeled estimate · not a bill or quote

What this hospital charges insurers

$861

About the fair price

about $40 under the fair price · 0.9× Medicare

Medicare pays $950 Fair price $901 This hospital $861 Cash price $1,261 Hospital's list price $4,204

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 $861

Black dot = this hospital, among the 9 TN hospitals with a price for this procedure. Full list below.

A fair price for a Colonoscopy (diagnostic) is about $901 (about 0.9× the $950 Medicare rate). Saint Thomas Highlands Hospital charges insurers about $861, or about $1,261 in cash — about the fair price. Located in Sparta, 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	$861	91%
Blue Cross Blue Shieldmajor	$861 - $904	91%
Aetnamajor	$878	92%
Cignamajor	$1,185 - $2,984	125%
Humanamajor	$861	91%
Ambetter (Centene)	$1,119	118%
Amerigroup	$861	91%
Cigna HealthSpring	$861	91%
Oscar Health	$1,205	127%
+ 6 smaller / regional plans	$395 - $1,205

Government programs also on file: Medicare.

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 1,261), 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 Saint Thomas Highlands Hospital 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 Saint Thomas Highlands Hospital

Compare: Colonoscopy (diagnostic) at other TN hospitals

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