CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Mon Health Medical Center

Billing Code: 45378 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$453

about 0.5× the $950 Medicare rate · typically $182–$854

modeled estimate · not a bill or quote

What this hospital charges insurers

$181

Below the fair price — a good deal

about $272 under the fair price · 0.2× Medicare

Medicare pays $950 Fair price $453 This hospital $181 Cash price $193 Hospital's list price $386

How we calculate the fair BaseRate →

How this hospital compares to other WV hospitals

A typical price — 4 charge more and 4 charge less, among the 9 WV hospitals compared.

Cheapest $107 Priciest $523

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

A fair price for a Colonoscopy (diagnostic) is about $453 (about 0.5× the $950 Medicare rate). Mon Health Medical Center charges insurers about $181, or about $193 in cash — below the fair price — a good deal. Located in Morgantown, WV.

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	$165	17%
Blue Cross Blue Shieldmajor	$165 - $252	17%
Aetnamajor	$165	17%
Cignamajor	$712	75%
Humanamajor	$282	30%
GEHA	$154	16%
Paramount	$165	17%
UPMC Health Plan	$449	47%
+ 9 smaller / regional plans	$155 - $348

Government programs also on file: Medicare.

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 193), 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 Mon Health 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 Mon Health Medical Center

Compare: Colonoscopy (diagnostic) at other WV hospitals

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