CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Northwest Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,025
  • Cash Discount Price: $3,310
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Northwest Medical Center is $1,025. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,310. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.08x the Medicare baseline. Located in 6200 North La Cholla Boulevard, Tucson, AZ.
Cash / Self-Pay
$3,310

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,025

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: $3,310 (348%)
Insurance Median: $1,025 (108%)
Cash: $3,310 (348% of Medicare)
Ins. Median: $1,025 (108% 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
Veterans Eval Services $320 34%
Medicaid / KanCare $570 - $610 60%
Magellan $598 - $1,025 63%
Aetna $976 - $6,206 103%
Cigna $976 - $3,883 103%
Humana $976 103%
Medicare (plans) $976 103%
Node Caremore Mcr Adv $976 103%
Scan Health Plan $976 103%
UnitedHealthcare $976 - $6,895 103%
Pascua Yaqui Tribe $982 103%
Blue Cross Blue Shield $992 - $3,608 104%
Department Of Veterans Affairs $992 104%
Node Non Par Hospice Agree $992 104%
Node Va $992 104%
Tricare $992 104%
Triwest $992 104%
Fresenius Health $996 105%
Node Clover Health Mcr Adv $1,002 105%
Node Devoted Health Mcr Adv $1,006 106%
Node Banner Mcr Adv $1,025 108%
Wellcare $1,025 108%
Node Us Dept Of Labor $1,240 131%
Ambetter / Centene $1,399 147%
Node Health Choice Health Exchange $1,459 154%
Health Net $1,573 166%
Node Fusion Network $1,786 188%
Node J Allen Inmate Health Svcs $1,885 198%
Seven Corners $2,282 240%
Self Pay $3,310 348%
First Health Coventry $7,240 762%
Coventry Medical Center $8,274 871%
Multiplan $11,446 1205%
Prime Health $11,722 1234%
Healthsmart $12,411 1306%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6200 North La Cholla Boulevard, Tucson, AZ 85741
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals