CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Prov Sacred Hrt Med Ctr & Childs Hosp.

Billing Code: 45378 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,889

about 2.0× the $950 Medicare rate · typically $1,188–$2,176

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,891

About the fair price

about $2 over the fair price · 2.0× Medicare

Medicare pays $950 Fair price $1,889 This hospital $1,891 Cash price $1,625 Hospital's list price $2,322

How we calculate the fair BaseRate →

How this hospital compares to other WA hospitals

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

Cheapest $165 Priciest $1,891

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

A fair price for a Colonoscopy (diagnostic) is about $1,889 (about 2.0× the $950 Medicare rate). Prov Sacred Hrt Med Ctr & Childs Hosp. charges insurers about $1,891, or about $1,625 in cash — about the fair price. Located in Spokane, WA.

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✓ Kaiser Permanente Humana

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	$1,088 - $3,438	115%
Blue Cross Blue Shieldmajor	$1,119 - $2,372	118%
Aetnamajor	$1,067 - $16,508	112%
Cignamajor	$1,244 - $8,066	131%
Kaiser Permanentemajor	$1,036 - $2,612	109%
Molina	$1,751	184%
Providence Health Plan	$2,637	278%
+ 3 smaller / regional plans	$1,140 - $2,368

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 1,625), 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 Prov Sacred Hrt Med Ctr & Childs Hosp. 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 Prov Sacred Hrt Med Ctr & Childs Hosp.

Compare: Colonoscopy (diagnostic) at other WA hospitals

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