CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Canyon Vista Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,072
Cash Discount Price: $2,415
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Canyon Vista Medical Center is $1,072. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,415. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.13x the Medicare baseline. Located in 5700 East Highway 90, Sierra Vista, AZ.

Cash / Self-Pay

$2,415

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,072

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: $2,415 (254%)

Insurance Median: $1,072 (113%)

Cash: $2,415 (254% of Medicare)

Ins. Median: $1,072 (113% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$531 - $1,062	56%
University Phyicians Inc	$764	80%
Azch-Complete Care Plan	$804	85%
Medicare (plans)	$857	90%
Wellcare By Allwell	$1,019	107%
UnitedHealthcare	$1,072 - $3,273	113%
Humana	$1,093	115%
Government Employees Health Association	$2,614	275%
Cigna	$3,562	375%
Blue Cross Blue Shield	$3,882	409%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $2,415.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 45378.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Canyon Vista Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 45378.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.