CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Stones River Hospital

Billing Code: 45378 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,277

about 1.3× the $950 Medicare rate · typically $628–$2,467

modeled estimate · not a bill or quote

What this hospital charges insurers

$873

Below the fair price — a good deal

about $404 under the fair price · 0.9× Medicare

Medicare pays $950 Fair price $1,277 This hospital $873 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 $873

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 $1,277 (about 1.3× the $950 Medicare rate). Stones River Hospital charges insurers about $873, or about $1,261 in cash — below the fair price — a good deal. Located in Woodbury, 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	$873	92%
Blue Cross Blue Shieldmajor	$873 - $917	92%
Aetnamajor	$891	94%
Cignamajor	$1,185 - $2,984	125%
Humanamajor	$873	92%
Ambetter (Centene)	$1,135	119%
Amerigroup	$873	92%
Cigna HealthSpring	$873	92%
Oscar Health	$1,222	129%
+ 6 smaller / regional plans	$395 - $1,222

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 Stones River 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 Stones River Hospital

Compare: Colonoscopy (diagnostic) at other TN hospitals

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