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CMS Price Transparency Data Hospital file updated: 2026-04-02

Colonoscopy (diagnostic)

Facility: Beloit Health System

Billing Code: 45378 (CPT)

Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Above Fair Market · Negotiate
$931Fair BaseRate (1.05× Market)
Position vs. 1.00× Fair Price+5% Above Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

This hospital's typical commercial price is $979 compared to the $931 fair price benchmark.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).86/100 · Verified
86/100Hover Any Check Below to See How Prices Were Audited
File Completeness90Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic88Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment86Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing83Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount84Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Quality Benchmark
CMS Star Rating3/5 StarsOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety Score60/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

3-Star CMS clinical quality rating paired with 1.05× fair market pricing.

The BaseRate · fair price medium confidence
A fair price for this
$931
about 1.0× the $950 Medicare rate · typically $476–$1,473
modeled estimate · not a bill or quote
What this hospital charges insurers
$979
About the fair price
about $48 over the fair price · 1.0× Medicare
Medicare pays $950 Fair price $931 This hospital $979 Cash price $722 Hospital's list price $2,407

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

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

Cheapest $153 Priciest $979

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

A fair price for a Colonoscopy (diagnostic) is about $931 (about 1.0× the $950 Medicare rate). Beloit Health System charges insurers about $979, or about $722 in cash — about the fair price. Located in Beloit, WI.

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

UnitedHealthcareBlue Cross Blue ShieldAetnaCignaHumana 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 $159 - $2,347 17%
Blue Cross Blue Shieldmajor $159 - $3,031 17%
Aetnamajor $159 - $2,594 17%
Cignamajor $2,162 - $2,594 228%
Humanamajor $642 - $3,641 68%
Dean Health Plan $159 - $4,948 17%
Molina $979 103%
Quartz $159 - $1,557 17%
WellCare $979 103%
+ 7 smaller / regional plans $159 - $3,915
Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 1969 W Hart Rd, Beloit, WI 53511
  • CMS Rating: 3 / 5 Stars
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals

Other Procedures at Beloit Health System

Compare: Colonoscopy (diagnostic) at other WI hospitals

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

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 36.3%

Audit a Bill or Quote at Beloit Health System (Zero PHI Required)

CMS CCN: 520100
CPT 45378
Fair BaseRate™ $931
Medicare Rate $950
Self-Pay Cash $722
Insurer Median $979
Pre-filled with Beloit Health System’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $874 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $874

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 = $874).

Step 2 · Cash vs. Insurance Arbitrage Save $1,685 Paying Cash

Self-Pay Cash Rate ($722) Beats Your Bill

Beloit Health System's published 45 CFR § 180 self-pay cash rate is $722 (vs. $979 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$1,476 Above Fair BaseRate

Negotiate Toward $931 Fair BaseRate ($950 Medicare)

Your bill ($2,407) is $1,476 above the denoised Fair BaseRate ($931) and 2.5× the $950 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.
CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall3/5 Stars (3/5)

Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

45 CFR § 180 Primary-Source Lineage & Federal Verification Verified CMS CCN 520100

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (export) Verify on CMS Medicare.gov (CCN 520100) ↗ CMS HCRIS Cost Reports ↗
Published MRF Fileexport
Publication / Vintage2026-04-02 · 177.70 MB
Validated Rate Rows2,443,606 (CMS v3.0.0)
File Integrity Digestcd106b495758df0a8445…

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.

Submit MRF Update Correction Policy