CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Medical Center Enterprise

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $851
  • Cash Discount Price: $2,968
  • vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Medical Center Enterprise is $851. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,968. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.90x the Medicare baseline. Located in 400 N Edwards Street, Enterprise, AL.
Cash / Self-Pay
$2,968

Average discount available for prompt cash payment at this facility.

Insurance Median
$851

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%)
Cash / Self-Pay: $2,968 (312%)
Insurance Median: $851 (90%)
Cash: $2,968 (312% of Medicare)
Ins. Median: $851 (90% 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.

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
Al Maternity Waiver Program $291 31%
Veterans Eval Services $294 31%
Medicaid / KanCare $383 - $631 40%
Blue Cross Blue Shield $789 - $1,282 83%
Humana $789 83%
Medicare (plans) $789 83%
UnitedHealthcare $789 - $2,468 83%
Select Health $797 84%
Covenant Hospice $801 84%
Dayspring Hospice $801 84%
Node Hospice Non Par $801 84%
Node Va $801 84%
Southerncare Hospice $801 84%
Healthspring $804 85%
Node Devoted Health Mcr Adv $804 85%
Node Clover Mcr Adv $810 85%
Aetna $812 - $23,082 85%
Node Wellcare Mcr Adv $818 86%
Eon Health $828 87%
Wiregrass Hospice $851 90%
Node Us Dept Of Labor $1,002 105%
Ambetter / Centene $1,202 127%
Cigna $1,305 - $8,495 137%
Occunet $1,403 148%
Self Pay $2,968 312%
Tricare $4,982 524%
Node Champva $5,244 552%
American Employee Alliance $13,190 1388%
Alamed $19,784 2082%
City Of Enterprise $19,784 2082%
Affordable Health $23,082 2429%
Health Choice $23,082 2429%
Novanet Ppo $23,082 2429%
Coventry Work Comp Al $24,269 2554%
Multiplan $24,401 - $25,390 2568%
Wc Dept Ind Relations $26,379 2776%
Corvel $28,028 2950%
Galaxy Health $29,677 3124%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 N Edwards Street, Enterprise, AL 36330
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals