CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Spanish Peaks Regional Health Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $542
  • Cash Discount Price: $542
  • vs. Medicare Baseline: 0.57x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Spanish Peaks Regional Health Center is $542. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $542. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.57x the Medicare baseline. Located in 23500 Us Highway 160, Walsenburg, CO.
Cash / Self-Pay
$542

Average discount available for prompt cash payment at this facility.

Insurance Median
$542

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: $542 (57%)
Insurance Median: $542 (57%)
Cash: $542 (57% of Medicare)
Ins. Median: $542 (57% 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
Blue Cross Blue Shield $295 - $542 31%
UnitedHealthcare $295 - $560 31%
Humana $300 32%
Medicare (plans) $300 32%
Devoted Health Mcr - All Plans $315 33%
Apostrophe - All Plans $542 57%
Cigna $542 57%
Friday Hp Chp - All Plans $542 57%
Kaiser Ppo - All Other Plans $542 57%
Prov Ntwrk Of America - All Plans $542 57%
Cofinity - All Plans $554 58%
Connect For Health - All Plans $560 59%
Rmhp - All Plans $560 59%
Multiplan Phcs - All Plans $572 60%
Kaiser Ppo Mcr $602 63%
Beacon Health Op Only-All Plans $1,401 147%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 23500 Us Highway 160, Walsenburg, CO 81089
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals