Colonoscopy (diagnostic)
Facility: Adventist Health Reedley
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $295
- Cash Discount Price: $118
- vs. Medicare Baseline: 0.31x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Central Ca Alliance Chdp Profee Only | $40 | 4% |
| Healthnet Medi-Cal | $93 | 10% |
| Blue Shield Mcare | $164 - $1,196 | 17% |
| Fhcn Pace Mcr Adv-All Plans | $164 - $1,196 | 17% |
| Lasalle Med Assoc Profee Only - All Plans | $164 | 17% |
| Sante Ipa Mcal/Mcare Hmo Profee Only | $164 | 17% |
| Tricare | $164 - $1,196 | 17% |
| UnitedHealthcare | $164 - $8,266 | 17% |
| Upn Mcr Adv Profee Only | $164 | 17% |
| Ah Employee Health Plan - All Plans | $181 - $2,153 | 19% |
| Aetna | $193 - $10,039 | 20% |
| Community Care Ipa Mcal-All Plans | $197 - $384 | 21% |
| Sante Ipa Hmo Profee Only - All Other Plans | $197 | 21% |
| Cigna | $216 - $405 | 23% |
| Kaiser - All Other Plans | $222 - $312 | 23% |
| Kaiser Mcr Adv | $222 - $1,196 | 23% |
| Western Growers/Pinnacle- All Plans | $229 - $10,215 | 24% |
| Healthnet- All Other Plans | $240 - $271 | 25% |
| Cal Viva Hlth Mcal - All Plans | $295 | 31% |
| Kern Health Systems Mcal-All Plans | $295 | 31% |
| Medi-Cal | $295 | 31% |
| Dignity Mcal Op/Profee Only-All Other Plans | $325 | 34% |
| Blue Shield Epn - All Other Plans | $338 - $590 | 36% |
| Blue Shield Non Epn | $389 - $623 | 41% |
| Physicians Med Group Op/Profee Only- All Plans | $498 | 52% |
| Bc Mcal | $570 | 60% |
| Blue Cross Blue Shield | $703 - $6,903 | 74% |
| Dignity Mcr Adv Op/Profee Only | $1,196 | 126% |
| Healthnet- Mcr Adv | $1,196 | 126% |
| Phs Prime Health Srvcs | $1,196 | 126% |
| Bright Health Mcr Adv - All Plans | $1,878 | 198% |