CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Anaheim Global Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $4,574
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 4.81x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Anaheim Global Medical Center is $4,574. 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 4.81x the Medicare baseline. Located in 1025 S Anaheim Blvd, Anaheim, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,574

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: $4,574 (481%)
Ins. Median: $4,574 (481% 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 481% of the Medicare baseline (a markup of 381%). 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
Medi-Cal Hmo/Non Contract $295 31%
Brand New Day $354 - $5,718 37%
Healthcare Partners $423 45%
Hollywood Presbyterian $423 45%
Kaiser $423 - $4,574 45%
Prime Health Services $423 - $5,261 45%
State Of California $423 - $1,591 45%
Altamed $593 - $4,574 62%
Caloptima $593 - $4,575 62%
Choc Health Alliance $593 62%
County Of Orange $593 - $5,718 62%
Family Choice Mcal $593 62%
Heritage Provider Network $593 - $4,574 62%
Prospect Health Plan $593 - $6,862 62%
Ihhi Reciprocity $1,200 126%
Coventry Health $1,432 - $1,487 151%
Interplan $1,448 152%
Multiplan $1,559 - $35,000 164%
Three Rivers Network $1,559 - $8,006 164%
Velocity National Provider Network Wc $1,591 167%
Aetna $2,138 - $4,574 225%
Monarch Health Plan $3,591 - $4,519 378%
Altamed Health Services $4,346 - $4,574 457%
Astiva $4,574 481%
Blue Shield Of California $4,574 - $17,428 481%
California Health Plan $4,574 481%
Central Health Plan Of California Inc $4,574 481%
Champion Health Plan $4,574 481%
Citizens Choice $4,574 481%
Clever Care Health Plan $4,574 481%
Easy Choice $4,574 481%
For Your Benefit $4,574 481%
Health Net Inc $4,574 481%
Healthcare Partners Sr Hmo $4,574 481%
Hollywood Presbyerian $4,574 481%
Humana $4,574 481%
Medicare (plans) $4,574 481%
Monarch $4,574 481%
Onecare $4,574 481%
Other Sr Non Contract $4,574 481%
Physicians For Healthy Hospitals $4,574 481%
Scan $4,574 481%
St Joseph Hospital Sr $4,574 481%
UnitedHealthcare $4,574 - $4,764 481%
Us Federal Marshall/Department Of Immigration $4,574 481%
Velocity National Provider Network Sr $4,574 481%
Verda Health Plan $4,574 481%
Veterans Administration $4,574 481%
Choice Physicians Network $4,575 482%
Imperial Health Plan Of Ca $4,575 482%
Innovative Integrated Health $4,575 482%
Medcare Partners Health Plan $4,575 482%
Self Pay/Ab774/Cbo Use Only $4,575 482%
Us Dept Of Labor $4,575 482%
Victim Of Violent Crime $4,575 482%
Victim Of Violent Crime (Mep) $4,575 482%
Victoria Hospice $4,575 482%
Champus $4,608 485%
Healthcare Partners Hmo $4,941 520%
Align Sr Care $5,123 539%
Veterans Evaluation Services $5,718 602%
Cigna $5,871 618%
Staywell/Island Home Ins $6,405 674%
Health Net $6,450 - $7,886 679%
Naphcare $7,091 746%
Healthsmart Preferred Network $37,500 3947%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1025 S Anaheim Blvd, Anaheim, CA 92805
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals