CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Boulder Community Health

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $324
  • Cash Discount Price: $180
  • vs. Medicare Baseline: 0.34x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Boulder Community Health is $324. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $180. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.34x the Medicare baseline. Located in 4747 Arapahoe Avenue, Boulder, CO.
Cash / Self-Pay
$180

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: $180 (19%)
Insurance Median: $324 (34%)
Cash: $180 (19% 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.

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
Rocky Mountain Health Maintenance Organization $83 - $944 9%
Aetna $123 - $916 13%
Medicare (plans) $137 - $944 14%
Select Health Colorado Public Option $137 - $2,016 14%
Select Health Value Network $137 - $2,135 14%
Beech Street Community Medical Associates $139 - $278 15%
Devoted Health $144 - $916 15%
Blue Cross Blue Shield $169 - $3,462 18%
Health Spring $169 - $916 18%
Humana $169 - $916 18%
Clear Spring $174 - $944 18%
UnitedHealthcare $179 - $941 19%
Multiplan $249 - $289 26%
Phcs $249 - $289 26%
Medicaid / KanCare $252 27%
Rocky Mountain Health Maintenance Organization Private Plan $252 27%
Kaiser Ppo $260 - $2,157 27%
Kaiser Public Option $260 - $1,757 27%
Integrated Health Plans Bch $270 28%
Colorado Access $277 - $519 29%
Cigna $288 - $4,092 30%
Casualty Management Network, Prime Health Services Behavioral Health $306 32%
Mines And Associates $306 32%
Three Rivers Provider Network $306 32%
Zelis (Profee) $306 32%
Casualty Management Network, Prime Health Services Community Medical Associates $324 34%
National Preferred Provider Network $324 34%
Rockport Healthcare Group Community Medical Associates $324 34%
Usa $324 34%
Rockport Healthcare Group Bch $335 35%
Health Payors Organization $342 36%
Health Management Network Bch Community Medical Associates $346 36%
Health Management Network Community Medical Associates $346 36%
National Provider Network $349 37%
Kaiser $2,147 226%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4747 Arapahoe Avenue, Boulder, CO 80304
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals