CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Adventist Health Ukiah Valley

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $228
Cash Discount Price: $125
vs. Medicare Baseline: 0.24x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Adventist Health Ukiah Valley is $228. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $125. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.24x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.

Cash / Self-Pay

$125

Average discount available for prompt cash payment at this facility.

Insurance Median

$228

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: $125 (13%)

Insurance Median: $228 (24%)

Cash: $125 (13% of Medicare)

Ins. Median: $228 (24% 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
Blue Cross Blue Shield	$66	7%
Blue Shield Mcr Adv	$164	17%
Kaiser Mcr Adv	$164	17%
Tricare	$164	17%
Ah Employee Health Plan - All Plans	$181	19%
Aetna	$206	22%
Cigna	$228	24%
UnitedHealthcare	$235 - $244	25%
Western Growers-All Plans	$235	25%
Healthnet-All Plans	$240	25%
Mendocino Lcc District-All Plans	$405	43%
Kaiser-All Other Plans	$498	52%
Three Rivers-All Plans	$561	59%
Blue Shield Epn-All Other Plans	$590	62%
Blue Shield Non-Epn	$623	66%

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 $125.
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 Adventist Health Ukiah Valley 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.