CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Kingman Regional Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $518
Cash Discount Price: $430
vs. Medicare Baseline: 0.55x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Kingman Regional Medical Center is $518. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $430. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.55x the Medicare baseline. Located in 3269 Stockton Hill Road, Kingman, AZ.

Cash / Self-Pay

$430

Average discount available for prompt cash payment at this facility.

Insurance Median

$518

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: $430 (45%)

Insurance Median: $518 (55%)

Cash: $430 (45% of Medicare)

Ins. Median: $518 (55% 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
Apipa - Ahcccs-All Other Plans	$158	17%
Health Choice Az	$158	17%
Health Choice Generations	$161	17%
Hpn Sierra Nevada Mcr Adv	$161	17%
Medicare (plans)	$161	17%
Triwest - All Plans	$161	17%
Care 1St Mcaid	$166	17%
Care 1St Mcr Adv-All Other Plans	$169	18%
Mercy Care Ahcccs Ddd	$174	18%
Mercy Care Adv Snp-All Other Plans	$177	19%
Humana	$181 - $499	19%
UnitedHealthcare	$206 - $537	22%
Geo Group Chc Az State Prison-All Plans	$242	25%
Aetna	$250	26%
Health Plan Of Nevada-All Other Plans	$250	26%
Health Choice Hie Exchange	$274	29%
Multiplan-All Plans	$274	29%
Blue Cross Blue Shield	$304	32%
Health Choice- All Other Plans	$403	42%
Cigna	$632	67%
Three Rivers-All Plans	$896 - $1,195	94%
America'S Choice Provider Network-All Plans	$925 - $1,234	97%
Az Foundation-All Plans	$974 - $1,299	103%
Mediversal-All Plans	$974 - $1,299	103%
One Health Plan-All Plans	$974 - $1,299	103%
Universal Health-All Plans	$974 - $1,299	103%

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 $430.
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 Kingman Regional 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.