CMS Price Transparency Data
Colonoscopy (diagnostic)
Facility: Mercy Hospital Northwest Arkansas
Billing Code: 45378 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 45378
- Insurance Median: $820
- Cash Discount Price: $1,837
- vs. Medicare Baseline: 0.86x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Mercy Hospital Northwest Arkansas is $820. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,837. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.86x the Medicare baseline. Located in 2710 South Rife Medical Lane, Rogers, AR.
Cash / Self-Pay
$1,837
Average discount available for prompt cash payment at this facility.
Insurance Median
$820
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: $1,837 (193%)
Insurance Median: $820 (86%)
Cash: $1,837 (193% of Medicare)
Ins. Median: $820 (86% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $160 - $1,169 | 17% |
| Indian Health Service Contracted [320198] | $160 | 17% |
| Indian Health Service [20198] | $160 | 17% |
| Mercy Interfacility [20513] | $361 | 38% |
| Aetna | $495 - $1,846 | 52% |
| Aither Health Contracted [320449] | $495 - $1,324 | 52% |
| Edison Health Solutions Contracted [320502] | $495 - $1,324 | 52% |
| Humana | $495 - $843 | 52% |
| Medicaid / KanCare | $495 - $1,171 | 52% |
| Mercy Benefit Admin Contracted [320251] | $495 - $1,324 | 52% |
| Yuzu Health Contracted [320521] | $495 - $1,324 | 52% |
| Ambetter / Centene | $688 - $1,171 | 72% |
| Home State Health Plan Contracted [320187] | $688 - $1,171 | 72% |
| Novasys Contracted [320285] | $688 - $1,387 | 72% |
| American Health Advantage Of Mo Mcr [20264] | $820 | 86% |
| Cherokee Nation Health Serv Contracted [320066] | $820 | 86% |
| Cigna | $820 - $1,030 | 86% |
| Cross Timbers Hospice [20098] | $820 | 86% |
| Dept Of Veteran Affairs Contracted [320106] | $820 | 86% |
| Elara Caring Aspire Hospice Contracted [320433] | $820 | 86% |
| Elara Caring Aspire Hospice [20433] | $820 | 86% |
| Globalhealth Contracted [320145] | $820 | 86% |
| Halo Hcr Inc Hospice Contracted [320432] | $820 | 86% |
| Halo Hcr Inc Hospice [20432] | $820 | 86% |
| Independent Health [20197] | $820 | 86% |
| Jordan Valley Senior Care Pace [20515] | $820 | 86% |
| Kindful Hospice Contracted [320434] | $820 | 86% |
| Kindful Hospice [20434] | $820 | 86% |
| Medical Associates Health [20444] | $820 | 86% |
| Medicare (plans) | $820 - $854 | 86% |
| Mercy Hospice Okc [20252] | $820 | 86% |
| Pace Of The Ozarks [20518] | $820 | 86% |
| Provider Partners Health Plans Contracted [320450] | $820 | 86% |
| Qual Choice Contracted [320325] | $820 | 86% |
| Spina Bifida Hlthcare Benefit [20506] | $820 | 86% |
| Tribute Health Plan Mcr [20338] | $820 | 86% |
| Tricare | $820 | 86% |
| UnitedHealthcare | $820 - $1,189 | 86% |
| Valir Pace [20503] | $820 | 86% |
| Wellfirst Health Mcr [20443] | $820 | 86% |
| St Johns Mercy Rehab Llc Contracted [320359] | $920 | 97% |
| St Johns Mercy Rehab Llc [20359] | $920 | 97% |
| 90 Degree Benefits Contracted [320436] | $990 | 104% |
| Show-Me Health Administrators Contracted [320483] | $990 | 104% |
| Usable Contracted [320409] | $1,040 - $1,169 | 109% |
| Auxiant Contracted [320462] | $1,189 - $1,288 | 125% |
| Ebms Contracted [320493] | $1,189 | 125% |
| Health Choice Contracted [320166] | $1,189 - $1,368 | 125% |
| Healthlink Contracted [320179] | $1,189 - $1,288 | 125% |
| Imagine 360 Contracted [320494] | $1,189 | 125% |
| Municipal Health Plan Contracted [320271] | $1,189 | 125% |
| Qual Choice Contracted [320324] | $1,189 | 125% |
| Reflect Health Contracted [320492] | $1,189 | 125% |
| United Medical Resources Contracted [320454] | $1,189 | 125% |
| Benefit Management Contracted [320052] | $1,288 | 136% |
| Federal Medical Center Contracted [320127] | $1,288 | 136% |
| Insurance System Inc Contracted [320465] | $1,288 | 136% |
| Personify Health Contracted [320051] | $1,288 | 136% |
| Point C Contracted [320238] | $1,288 | 136% |
| Preferred Health Plan Contracted [320522] | $1,288 | 136% |
| Tri State Healthcare Coalition Contracted [320379] | $1,288 | 136% |
| Workers Comp [20426] | $1,288 | 136% |
| Private Health Care Systems Contracted [320320] | $1,446 | 152% |
| Private Health Care Systems [20320] | $1,446 | 152% |
| Ppo Plus Contracted [320310] | $1,486 | 156% |
| Healthscope Contracted [320182] | $1,585 | 167% |
| Multiplan Contracted [320270] | $1,684 | 177% |
| Multiplan [20270] | $1,684 | 177% |