CMS Price Transparency Data
Colonoscopy (diagnostic)
Facility: Uc San Diego Health Hillcrest - Hillcrest Med Ctr
Billing Code: 45378 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 45378
- Insurance Median: $2,064
- Cash Discount Price: $3,275
- vs. Medicare Baseline: 2.17x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Uc San Diego Health Hillcrest - Hillcrest Med Ctr is $2,064. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,275. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 2.17x the Medicare baseline. Located in 200 West Arbor Drive, San Diego, CA.
Cash / Self-Pay
$3,275
Average discount available for prompt cash payment at this facility.
Insurance Median
$2,064
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: $3,275 (345%)
Insurance Median: $2,064 (217%)
Cash: $3,275 (345% of Medicare)
Ins. Median: $2,064 (217% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 217% of the Medicare baseline (a markup of 117%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Aetna | $50 - $4,055 | 5% |
| Alternate Medi-Cal [2001] | $50 - $423 | 5% |
| Blue Cross Blue Shield | $50 - $7,505 | 5% |
| Blue Shield Promise [1017] | $50 - $487 | 5% |
| Brand New Day [1089] | $50 - $423 | 5% |
| Caremore [2028] | $50 - $423 | 5% |
| Community Eldercare [1027] | $50 - $423 | 5% |
| Medi-Cal [1048] | $50 - $423 | 5% |
| Vantage [1092] | $50 - $4,809 | 5% |
| Ximed [2016] | $50 - $423 | 5% |
| Alternate Molina [1240] | $63 - $534 | 7% |
| Molina [1055] | $63 - $534 | 7% |
| Community Health Group [1022] | $64 - $546 | 7% |
| Health Net [1039] | $68 - $10,939 | 7% |
| Champva [1020] | $389 - $8,015 | 41% |
| Federal Prison [1031] | $389 - $801 | 41% |
| Mid County Physicians Med Grp [1054] | $389 - $2,885 | 41% |
| Alameda Alliance For Health [2027] | $423 | 45% |
| Alignment Health Plan [2020] | $423 | 45% |
| California Department Of Public Health [1237] | $423 | 45% |
| California Health & Wellness Medi-Cal [1122] | $423 | 45% |
| Cms - County Medical Services [1025] | $423 - $5,210 | 45% |
| Community Care Ipa [1131] | $423 | 45% |
| Gold Coast Health Plan [2031] | $423 | 45% |
| Health Plan Of San Joaquin [2032] | $423 | 45% |
| Hemet Community Med Grp - Promisecare [1040] | $423 | 45% |
| Imperial Health Holdings [1132] | $423 | 45% |
| Kern Health Systems [2033] | $423 | 45% |
| La Care Health Plan [2025] | $423 | 45% |
| Medicaid / KanCare | $423 | 45% |
| Regal Mg 'Heritage Provider Network' [2019] | $423 | 45% |
| San Diego County [1071] | $423 - $4,007 | 45% |
| Sd Physicians Med Grp [1076] | $423 - $5,210 | 45% |
| State Of California [1082] | $423 | 45% |
| UnitedHealthcare | $423 - $5,610 | 45% |
| Unlisted Mcal Hmo Non-Contract [1049] | $423 | 45% |
| Cigna | $467 - $4,809 | 49% |
| Humana | $467 - $6,813 | 49% |
| Mc Blue Shield Generic Payor [164016] | $467 - $962 | 49% |
| Mc Blue Shield Hmo [164015] | $467 - $962 | 49% |
| Mc Brand New Day Generic Payor [164031] | $467 - $962 | 49% |
| Mc Brand New Day Hmo [164030] | $467 - $962 | 49% |
| Mc Healthnet Generic Payor [164010] | $467 - $962 | 49% |
| Mc Healthnet Hmo [164004] | $467 - $962 | 49% |
| Mc Hnet Blue&Gold Aco [164017] | $467 - $962 | 49% |
| Mc Scan Generic Payor [164034] | $467 - $962 | 49% |
| Mc Scan Hmo [164035] | $467 - $962 | 49% |
| Uc Aff Blue Shield Sr/Sdsm [164037] | $467 - $962 | 49% |
| Inland Empire Health Plan Transplant [1126] | $593 | 62% |
| Inland Empire Health Plan [1121] | $593 | 62% |
| Cal Optima [1016] | $614 | 65% |
| Padres Workers Compensation [2013] | $627 - $1,290 | 66% |
| Padres [2014] | $627 - $1,290 | 66% |
| Ucr Prompt Pay Payor [8240] | $745 | 78% |
| Alternate Scan Health [2088] | $1,158 - $1,557 | 122% |
| Scan Health [1072] | $1,158 - $1,557 | 122% |
| Alternate Healthnet [1007] | $1,351 - $3,893 | 142% |
| Multicultural Med Grp [1057] | $1,413 - $2,909 | 149% |
| Elizabeth Hospice [2018] | $1,557 - $3,206 | 164% |
| Scripps Clinic [1073] | $1,557 - $4,809 | 164% |
| Blue Shield [1014] | $1,651 - $10,382 | 174% |
| Alternate Health Net Bh [2059] | $1,888 - $3,887 | 199% |
| Healthnet Transplants [1114] | $1,888 - $3,887 | 199% |
| Usoc - Us Olympic Committee [1123] | $1,923 - $3,959 | 202% |
| Global Excel [1036] | $1,946 - $4,007 | 205% |
| Sharp Health Plan [1079] | $1,946 - $4,047 | 205% |
| Graybill Med Grp [1037] | $1,966 - $4,047 | 207% |
| Sharp Community Med Grp [1078] | $1,966 - $4,047 | 207% |
| Sharp Rees Stealy [1080] | $1,966 - $4,047 | 207% |
| Olympus Managed Healthcare Inc [1102] | $1,970 - $4,055 | 207% |
| Scripps Health Plan Services [1075] | $2,336 - $4,809 | 246% |
| Alternate Sheriff Custody [1106] | $2,530 - $5,210 | 266% |
| Arch Health Partners [2000] | $2,530 - $5,210 | 266% |
| Axa Assistance [1098] | $2,530 - $5,210 | 266% |
| Cassidy Med Grp [1019] | $2,530 - $5,210 | 266% |
| Cmn - Canadian Medical Network [1024] | $2,530 - $5,210 | 266% |
| Ets - Lifetrac Network [1103] | $2,530 - $5,210 | 266% |
| Health Net Bh (Mhn) [1038] | $2,530 - $5,210 | 266% |
| Health Net Bh (Mhn) [2010] | $2,530 - $5,210 | 266% |
| Interlink Health Services Transplant [1124] | $2,530 - $5,210 | 266% |
| Interlink Health Transplant [2085] | $2,530 - $5,210 | 266% |
| Mgm Resorts [1053] | $2,530 - $5,210 | 266% |
| National Healthcare Solutions Inc [1100] | $2,530 - $5,210 | 266% |
| Quality Health [1069] | $2,530 - $5,210 | 266% |
| San Diego County Sheriff Custody [2012] | $2,530 - $5,210 | 266% |
| Scripps Coastal Med Grp [1074] | $2,530 - $5,210 | 266% |
| Tri-City [1085] | $2,530 - $5,210 | 266% |
| Kaiser [1046] | $2,608 - $5,370 | 274% |
| Embassy Sponsored [1101] | $2,647 - $5,610 | 279% |
| Interplan [1045] | $2,725 - $5,610 | 287% |
| Mercy Physicians Med Grp [1052] | $2,725 - $5,610 | 287% |
| Pacific Foundation [1063] | $2,725 - $5,610 | 287% |
| Beech Street [1012] | $2,920 - $6,011 | 307% |
| First Health [1032] | $2,920 - $6,011 | 307% |
| Admar [1001] | $2,998 - $6,171 | 316% |
| Bps - Benefit Plan Services [1015] | $2,998 - $6,171 | 316% |
| Multiplan [1058] | $2,998 - $6,171 | 316% |
| Private Healthcare Systems [1067] | $2,998 - $8,015 | 316% |
| Carnival Cruises [1018] | $3,114 - $6,412 | 328% |
| Alternate Kaiser Rad Onc [2089] | $3,893 - $8,015 | 410% |
| Chargers Football Company [1109] | $3,893 | 410% |
| Palomar Health [1128] | $4,672 | 492% |
| Easy Choice [1029] | $4,866 | 512% |
| Sharp Healthcare Transplant [1119] | $5,256 - $10,820 | 553% |
| Alternate Blue Shield [2002] | $10,382 | 1093% |
| Blue Shield Transplants [1113] | $10,382 | 1093% |