CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: University of Alabama Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $3,968
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 4.18x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at University of Alabama Hospital is $3,968. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 4.18x the Medicare baseline. Located in 619 South 19Th Street, Birmingham, AL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,968

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$950.1

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $950.1 (100%)
Insurance Median: $3,968 (418%)
Ins. Median: $3,968 (418% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $950.1 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 418% of the Medicare baseline (a markup of 318%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Viva $480 - $1,984 51%
Humana $751 - $4,216 79%
Birmingham Fc $816 86%
Blue Cross Blue Shield $816 86%
Cooper Green $816 86%
Davita Villagehealth $816 86%
Jefferson County Sheriff $816 86%
Triwest $816 86%
UnitedHealthcare $816 - $4,416 86%
Cigna $873 - $3,782 92%
Ambetter / Centene $1,122 118%
University Of Alabama $2,480 261%
Aetna $3,026 318%
Coventry $3,224 - $4,005 339%
North Alabama Managed Care $3,224 339%
Comp One $3,571 376%
Construction Claims Management $3,710 390%
Alamed $3,720 392%
Corvel $3,968 418%
Evolutions $3,968 - $4,464 418%
Healthcare Alliance $3,968 418%
Novanet $3,968 - $4,464 418%
Prime Health Services $3,968 - $4,464 418%
Select Value Care $3,968 418%
Starcare $3,968 418%
Tethys $3,968 418%
Multiplan $4,067 428%
Department Of Labor $4,216 444%
Geha $4,216 444%
Gulf Health Plans $4,216 444%
Heritage Summit Health $4,216 444%
Mississippi Physicians $4,216 444%
Phifer $4,216 444%
Preferred Health Partnership $4,216 444%
Southern Nuclear $4,216 444%
Vantage Health Plan $4,216 444%
Galaxy Health Network $4,464 470%
National Provider Network $4,464 470%
North Mississippi Health Link $4,464 470%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 619 South 19Th Street, Birmingham, AL 35233
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals