CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Oro Valley Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,133
  • Cash Discount Price: $3,037
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Oro Valley Hospital is $1,133. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,037. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.19x the Medicare baseline. Located in 1551 East Tangerine Road, Oro Valley, AZ.
Cash / Self-Pay
$3,037

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,133

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: $3,037 (320%)
Insurance Median: $1,133 (119%)
Cash: $3,037 (320% of Medicare)
Ins. Median: $1,133 (119% 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 - $7,593 63%
Aetna $976 - $2,736 103%
Caremore Health Plan $976 103%
Cigna $976 - $3,883 103%
Humana $976 103%
Medicare (plans) $976 103%
Scan Health $976 103%
UnitedHealthcare $976 - $2,517 103%
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 Triwest $992 104%
Node Va $992 104%
Tricare $992 104%
Fresenius Health $996 105%
Clover Health Mcr Adv $1,002 105%
Node Devoted Health Mcr Adv $1,006 106%
Node Banner Mcr Adv $1,025 108%
Wellcare Mcr Adv $1,025 108%
Node Us Dept Of Labor $1,240 131%
Ambetter / Centene $1,399 147%
Node Health Choice Exchange $1,479 156%
Node Fusion Network $1,786 188%
Node J Allen Inmate Health Svcs $1,885 198%
Health Net $2,084 219%
Seven Corners $2,282 240%
Self Pay $3,037 320%
Beacon Health Options $6,327 666%
Mtc $6,327 666%
First Health Coventry $6,644 699%
Coventry Work Comp Al $7,593 799%
Multiplan $10,503 1105%
Prime Health $10,756 1132%
Three Rivers $10,756 1132%
Healthsmart $11,389 1199%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1551 East Tangerine Road, Oro Valley, AZ 85755
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals