CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Arrowhead Regional Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,196
Cash Discount Price: $4,812
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Arrowhead Regional Medical Center is $1,196. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,812. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.26x the Medicare baseline. Located in 400 North Pepper Avenue, Colton, CA.

Cash / Self-Pay

$4,812

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,196

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: $4,812 (506%)

Insurance Median: $1,196 (126%)

Cash: $4,812 (506% of Medicare)

Ins. Median: $1,196 (126% 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.

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
Alpha Care	$295	31%
Inland Faculty Medical Group	$295 - $1,196	31%
La Health Care	$295	31%
Lasalle Medical Associates	$295	31%
Physician Health Network	$295	31%
Inland Empire Health Plan	$325 - $1,196	34%
Molina	$396 - $1,375	42%
Innovage	$1,196	126%
Kaiser Foundation	$1,196 - $2,854	126%
Triwest	$1,196	126%
Correctional Health Partners	$1,555	164%
Wellpath	$1,675 - $2,406	176%
Multiplan	$3,465	365%
Blue Cross Blue Shield	$3,489	367%

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 $4,812.
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 Arrowhead Regional 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.