CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: John Muir Medical Center - Concord Campus

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,422
  • Cash Discount Price: $11,400
  • vs. Medicare Baseline: 1.50x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at John Muir Medical Center - Concord Campus is $1,422. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,400. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.50x the Medicare baseline. Located in 2540 East St, Concord, CA.
Cash / Self-Pay
$11,400

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,422

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: $11,400 (1200%)
Insurance Median: $1,422 (150%)
Cash: $11,400 (1200% of Medicare)
Ins. Median: $1,422 (150% 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.

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
Jmpn Canopy Hn [1640000011] $246 26%
UnitedHealthcare $246 - $21,354 26%
Contra Costa County Jail [1012104] $295 31%
Tricare $1,230 129%
Health Net-Network Mcare [1028127] $1,287 135%
Aetna $1,313 - $12,599 138%
Alignment Health [1177113] $1,313 138%
Blue Cross Blue Shield $1,313 - $11,715 138%
Blue Shield-Network Mcare [1006127] $1,313 138%
Care 1St Health Plan [1094113] $1,313 138%
Caremore [1171113] $1,313 138%
Covid19 Hrsa Uninsured Testing And Treatment Fund [1179012] $1,313 138%
Easy Choice Health Plan [1083113] $1,313 138%
Essence Healthcare [1049028] $1,313 138%
Essence Healthcare [1049128] $1,313 138%
Golden State-Network Mcare [1023127] $1,313 138%
Hospice Of East Bay [1085104] $1,313 138%
Humana $1,313 138%
Medicare (plans) $1,313 138%
Scan-Network Mcare [1043127] $1,313 138%
Veterans Administration [1051113] $1,313 138%
Workers' Comp [1024005] $1,422 150%
Generic Commercial/Indemnity [1017001] $1,641 173%
Generic Hmo [1018103] $1,641 173%
Generic Ppo [1021104] $1,641 173%
Canopy Hn Hmo [1166103] $2,403 253%
Donor Network West [1008103] $4,000 421%
Brms [1091104] $5,911 - $11,715 622%
Delta Health Systems [1032104] $5,911 - $11,715 622%
Empire Plan [1092104] $5,911 - $11,715 622%
Healthcomp [1089104] $5,911 - $11,715 622%
Blue Shield Hmo [1006103] $10,787 - $11,574 1135%
Blue Shield-Network [1006026] $10,787 - $11,574 1135%
Blue Shield Ppo [1006104] $11,729 - $15,143 1235%
Cigna $12,628 - $15,785 1329%
United Behavioral Health [1048103] $21,354 2248%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2540 East St, Concord, CA 94520
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals