CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Sharp Chula Vista Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $2,064
Cash Discount Price: $2,537
vs. Medicare Baseline: 2.17x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Sharp Chula Vista Medical Center is $2,064. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,537. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 2.17x the Medicare baseline. Located in 751 Medical Center Court, Chula Vista, CA.

Cash / Self-Pay

$2,537

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: $2,537 (267%)

Insurance Median: $2,064 (217%)

Cash: $2,537 (267% 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.

Consult Patient Advocate

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
Molina	$214 - $2,605	23%
UnitedHealthcare	$214 - $2,537	23%
Aetna	$474 - $2,774	50%
Allianz Global Assistance	$947 - $2,706	100%
Blue Shield	$947 - $2,774	100%
Community Health Group	$1,005 - $2,706	106%
Humana	$1,005 - $2,605	106%
Medicare (plans)	$1,005 - $2,605	106%
Kaiser	$1,015 - $2,706	107%
Blue Cross Blue Shield	$1,150 - $2,774	121%
Health Net	$1,150 - $2,537	121%
San Diego Pace	$1,150 - $1,692	121%
California Health And Wellness	$1,328 - $2,368	140%
Interplan	$1,421 - $2,300	150%
Cigna	$1,566 - $3,045	165%
County Medical Services	$1,708 - $3,045	180%
Managed Health Network	$1,911 - $2,334	201%
Medi-Cal	$2,284 - $2,334	240%
Indian Health Council	$2,300	242%
Epic Americas	$2,368 - $3,045	249%

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 $2,537.
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 Sharp Chula Vista 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.