CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Adventist Health Howard Memorial

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $324
Cash Discount Price: $187
vs. Medicare Baseline: 0.34x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Adventist Health Howard Memorial is $324. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $187. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.34x the Medicare baseline. Located in 1 Marcela Dr, Willits, CA.

Cash / Self-Pay

$187

Average discount available for prompt cash payment at this facility.

Insurance Median

$324

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: $187 (20%)

Insurance Median: $324 (34%)

Cash: $187 (20% of Medicare)

Ins. Median: $324 (34% 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
Blue Shield Mcare	$125 - $164	13%
Tricare	$125 - $164	13%
Medicare (plans)	$126 - $164	13%
UnitedHealthcare	$137 - $482	14%
Ah Employee Health Plan - All Plans	$181 - $324	19%
Aetna	$206 - $418	22%
Cigna	$216 - $530	23%
Western Growers/Pinnacle - All Plans	$235 - $467	25%
Healthnet - All Plans	$240 - $511	25%
Medi-Cal	$295	31%
First Health Ppo - All Plans	$498	52%
Ghn Ppo - All Plans	$498	52%
Brms - All Plans	$530	56%
Blue Shield - All Other Plans	$623 - $8,286	66%
Blue Cross Blue Shield	$758 - $7,520	80%
Blue Shield Epn	$8,005	843%

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 $187.
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 Adventist Health Howard Memorial 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.