CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Loma Linda University Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $2,329
  • Cash Discount Price: $2,249
  • vs. Medicare Baseline: 2.45x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Loma Linda University Medical Center is $2,329. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,249. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 2.45x the Medicare baseline. Located in 11234 Anderson St, Loma Linda, CA.
Cash / Self-Pay
$2,249

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,329

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: $2,249 (237%)
Insurance Median: $2,329 (245%)
Cash: $2,249 (237% of Medicare)
Ins. Median: $2,329 (245% 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 245% of the Medicare baseline (a markup of 145%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Inland Empire Health Plan (Iehp) $508 - $1,158 53%
Kaiser Foundation Hospitals $561 - $4,077 59%
Adventist Health $776 - $1,222 82%
Lluh Dept Of Risk Management $776 - $1,222 82%
Center For Health Promotion $846 89%
Alpha Care Medical Group $1,158 - $1,738 122%
Dignity Health $1,158 - $1,738 122%
Epic Health Plan $1,158 - $2,445 122%
UnitedHealthcare $1,158 - $7,378 122%
Upland Medical Group $1,158 122%
Vantage Medical Group $1,158 - $1,738 122%
Prime Health Services $1,228 - $5,195 129%
Riverside University Health System $1,274 134%
Trivalley Medical Group $1,390 146%
Molina Healthcare Of Ca $1,552 163%
Heritage Provider Network $1,900 200%
Global Benefits Group $2,329 - $3,667 245%
Temecula Valley Physicians Medical Group $2,329 245%
Cigna $2,484 - $2,873 261%
Networks By Design $2,523 - $3,973 266%
Multiplan $2,912 - $4,584 306%
Central Health Plan $3,106 - $4,890 327%
Blue Shield Of California $3,166 - $4,245 333%
Galaxy Health $3,300 - $5,195 347%
Health Management Network $3,494 - $5,501 368%
Blue Cross Blue Shield $4,736 - $6,333 498%
Aetna $6,248 658%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11234 Anderson St, Loma Linda, CA 92354
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals