CMS Price Transparency Data
Colonoscopy (diagnostic)
Facility: Whittier Hospital Medical Center
Billing Code: 45378 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 45378
- Insurance Median: $1,177
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Whittier Hospital Medical Center is $1,177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.24x the Medicare baseline. Located in 9080 Colima Rd, Whittier, CA.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,177
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%)
Insurance Median: $1,177 (124%)
Ins. Median: $1,177 (124% 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 |
|---|---|---|
| Applecare Medical Group | $207 | 22% |
| Ahmc Medi-Cal Reciprocity Agreement | $295 | 31% |
| Aids Healthcare Foundation | $295 - $1,177 | 31% |
| Allied Physicians | $295 - $1,794 | 31% |
| Alta Med Health Network | $295 - $1,177 | 31% |
| Altamed Health Services Corporation | $295 | 31% |
| Beverly Hospital | $295 - $1,316 | 31% |
| Brand New Day | $295 - $1,471 | 31% |
| Emanate Health | $295 - $1,470 | 31% |
| Health Net | $295 - $1,177 | 31% |
| Healthy Way La | $295 | 31% |
| Heritage Provider Network | $295 - $1,615 | 31% |
| Kaiser Foundation | $295 - $4,186 | 31% |
| La Care Healthy Families/Healthy Kids | $295 | 31% |
| Non Contracted Medi-Cal | $295 | 31% |
| Prospect Health Plan | $295 - $1,914 | 31% |
| Synermed | $295 - $1,196 | 31% |
| La Care Health Plan | $340 - $1,177 | 36% |
| Prospect Medical | $350 | 37% |
| Monarch Healthplan | $413 | 43% |
| Avanti | $423 - $1,435 | 45% |
| Care First Health Plan | $423 | 45% |
| County Of Los Angeles Dept Of Health Services | $423 | 45% |
| Hollywood Presbyterian Adv Med Mcal | $423 | 45% |
| Hollywood Presbyterian Medpoint Mcal | $423 | 45% |
| Medi Caid/ Medi Cal | $423 | 45% |
| Central Health Plan Of California | $477 | 50% |
| Pacific Independent Physician Association | $500 - $1,400 | 53% |
| Aetna | $572 - $1,707 | 60% |
| Medicare (plans) | $635 - $1,236 | 67% |
| Davita Healthcare Partners | $637 | 67% |
| Molina Medical Center | $663 - $1,495 | 70% |
| UnitedHealthcare | $709 - $3,700 | 75% |
| Universal Care | $820 - $1,100 | 86% |
| Veterans Administration | $837 | 88% |
| Alta Los Angeles Hospitals Inc | $1,177 | 124% |
| Apa/Aco Inc | $1,177 | 124% |
| Blue Cross Blue Shield | $1,177 - $2,432 | 124% |
| Caloptima | $1,177 | 124% |
| Central Health Plan | $1,177 | 124% |
| Easy Choice Health Plan | $1,177 | 124% |
| Humana | $1,177 | 124% |
| Pacificare Of California | $1,177 | 124% |
| Scan Health Plan | $1,177 | 124% |
| Blue Shield Of California | $1,196 - $1,992 | 126% |
| Caremore | $1,196 | 126% |
| Cov19 Hrsa Uninsured Testing And Treatment Fund | $1,196 | 126% |
| La Care Covered Direct | $1,196 | 126% |
| Pacific Alliance Medical Center | $1,196 | 126% |
| Private Pay | $1,196 | 126% |
| Self-Pay | $1,196 | 126% |
| Alignment Health Plan | $1,236 | 130% |
| Molina Healthcare Of California | $1,236 | 130% |
| San Miguel Health Plan | $1,316 | 139% |
| Chinatown Service Center Pace | $1,435 | 151% |
| Ahmc Health | $1,495 | 157% |
| Knox-Keene Act | $1,495 | 157% |
| Fmc Los Angeles County | $1,511 | 159% |
| Interplan Health Group | $1,543 | 162% |
| Athens Administrators Ahmc Work Comp | $1,591 | 167% |
| Misc 1 | $1,591 | 167% |
| Multiplan Wc | $1,591 | 167% |
| Capnet | $2,000 | 211% |
| Edward Medical Group | $2,000 | 211% |
| Great-West Healthcare Of California | $2,500 | 263% |
| Prohealth | $2,500 | 263% |
| Care 1St Health Plan | $2,600 - $4,500 | 274% |
| Cost Containment | $2,800 | 295% |
| Health Net Inc | $2,933 - $3,073 | 309% |
| Healthnet | $3,589 | 378% |
| Tricare | $4,875 | 513% |