CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Loma Linda University Medical Center-Murrieta

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,425
Cash Discount Price: $1,836
vs. Medicare Baseline: 1.50x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Loma Linda University Medical Center-Murrieta is $1,425. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,836. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.50x the Medicare baseline. Located in 28062 Baxter Road, Murrieta, CA.

Cash / Self-Pay

$1,836

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,425

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: $1,836 (193%)

Insurance Median: $1,425 (150%)

Cash: $1,836 (193% of Medicare)

Ins. Median: $1,425 (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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Trivalley Medical Group	$425	45%
Inland Empire Health Plan (Iehp)	$478 - $1,158	50%
Kaiser Foundation Hospitals	$703 - $1,852	74%
Adventist Health	$776 - $855	82%
Lluh Dept Of Risk Management	$970 - $1,069	102%
Alpha Care Medical Group	$1,158 - $1,738	122%
Dignity Health	$1,158 - $1,738	122%
Epic Health Plan	$1,158 - $9,616	122%
Vantage Medical Group	$1,158 - $1,738	122%
Heritage Provider Network	$1,425 - $2,896	150%
Molina Healthcare Of Ca	$1,460	154%
Cigna	$2,523	266%
Aetna	$2,667	281%
Multiplan	$2,912 - $3,208	306%
UnitedHealthcare	$2,984 - $3,544	314%
Blue Cross Blue Shield	$3,531	372%
Blue Shield Of California	$7,178 - $8,962	755%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,836.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 45378.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Loma Linda University Medical Center-Murrieta is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 45378.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.