CMS Price Transparency Data
Colonoscopy (diagnostic)
Facility: Menifee Global Medical Center
Billing Code: 45378 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 45378
- Insurance Median: $1,432
- Cash Discount Price: $5,364
- vs. Medicare Baseline: 1.51x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Menifee Global Medical Center is $1,432. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,364. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.51x the Medicare baseline. Located in 28400 McCall Boulevard, Sun City, CA.
Cash / Self-Pay
$5,364
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,432
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: $5,364 (565%)
Insurance Median: $1,432 (151%)
Cash: $5,364 (565% of Medicare)
Ins. Median: $1,432 (151% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Tricare | $342 - $4,680 | 36% |
| Lasalle Medical Assoc (Ancillary) Mcal Hmo | $348 | 37% |
| Health Net Medi-Cal | $423 | 45% |
| Ic | $423 - $5,364 | 45% |
| Kaiser Medi-Cal | $423 | 45% |
| Prospect Health Plan Mcal Hmo | $436 | 46% |
| Blue Cross Blue Shield | $445 | 47% |
| Molina Medi-Cal | $500 | 53% |
| Health Net Enhanced Ppo | $564 - $1,666 | 59% |
| Altamed Mcal Hmo | $593 | 62% |
| Altamed Mcal/Pace | $593 | 62% |
| Iehp Medi-Cal | $635 | 67% |
| Molina Covered Ca | $1,156 - $4,582 | 122% |
| Aetna | $1,190 - $3,224 | 125% |
| Altamed Comm Hmo (Ancillary) | $1,190 - $5,364 | 125% |
| Altamed Health Services Senior | $1,190 | 125% |
| Altamed Sr/Pace | $1,190 | 125% |
| Blue Shield Senior | $1,190 | 125% |
| Central Health Plan Senior | $1,190 | 125% |
| Clever Care Health Plan Sr | $1,190 | 125% |
| For Your Benefit Senior | $1,190 | 125% |
| Guidant Health Plan Senior | $1,190 | 125% |
| Health Net Senior | $1,190 | 125% |
| Hpn Senior | $1,190 | 125% |
| Humana | $1,190 | 125% |
| Kaiser Senior | $1,190 | 125% |
| Lasalle Medical Assoc (Ancillary) Senior | $1,190 | 125% |
| Managed Health Network Sr | $1,190 | 125% |
| Medicare (plans) | $1,190 | 125% |
| Neighborhood Healthcare Pace | $1,190 | 125% |
| Primecare Senior | $1,190 | 125% |
| Prospect Health Plan Sr Hmo | $1,190 | 125% |
| Scan Senior | $1,190 | 125% |
| Sr Capitation | $1,190 | 125% |
| UnitedHealthcare | $1,190 - $2,212 | 125% |
| Veterans Administration | $1,190 | 125% |
| Imperial Health Plan Of Ca | $1,196 | 126% |
| Lasalle Medical Assoc (Ancillary) Commercial | $1,196 | 126% |
| Point Comfort Underwriters | $1,196 | 126% |
| Self Pay/Ab774/Charity Discount | $1,196 | 126% |
| Align Senior Care | $1,333 | 140% |
| Welbehealth Sr/Pace | $1,333 | 140% |
| Prime Health Services Senior | $1,369 | 144% |
| Coventry | $1,432 - $1,487 | 151% |
| Prime Health Services Wcomp | $1,432 | 151% |
| Iehp Covered Ca | $1,488 | 157% |
| Three Rivers Wcomp | $1,559 | 164% |
| Workers Comp Non-Contracted | $1,591 | 167% |
| Prospect Health Plan Comm Hmo | $1,607 | 169% |
| Hpn Commercial/Covered Ca | $1,666 | 175% |
| Cigna | $1,699 - $4,291 | 179% |
| Health Net Comm | $1,785 | 188% |
| Three Rivers Network | $2,093 | 220% |
| Velocity | $2,093 - $2,414 | 220% |
| First Health Commercial | $2,816 | 296% |
| Hpn Mcal | $2,950 | 310% |
| Blue Shield Epn | $3,345 | 352% |
| Choice Physicians Network | $3,487 - $5,200 | 367% |
| Primecare Commercial | $3,487 | 367% |
| Multiplan Ppo | $3,755 | 395% |
| Multiplan Wcomp | $3,755 | 395% |
| Blue Shield Commercial | $3,940 | 415% |
| Pnoa-Provider Network Of America | $4,291 | 452% |
| Prime Health Services Commercial | $4,291 | 452% |
| Ava Hospice | $5,364 | 565% |
| Kaiser Commercial | $5,364 | 565% |
| Living Waters Hospice | $5,364 | 565% |
| Managed Health Network | $5,364 | 565% |
| Other Insurance Loa | $5,364 | 565% |
| Pacific Valley Hospice | $5,364 | 565% |
| Private Pay | $5,364 | 565% |
| Silverado Hospice | $5,364 | 565% |
| Vna Hospice | $5,364 | 565% |