CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: UF Health Shands Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,049
Cash Discount Price: $2,483
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at UF Health Shands Hospital is $1,049. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,483. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.10x the Medicare baseline. Located in 1600 Sw Archer Rd, Gainesville, FL.

Cash / Self-Pay

$2,483

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,049

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: $2,483 (261%)

Insurance Median: $1,049 (110%)

Cash: $2,483 (261% of Medicare)

Ins. Median: $1,049 (110% 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
Beacon Health Strategies	$701	74%
Humana	$701 - $981	74%
Sunshine State Health Plan	$701	74%
UnitedHealthcare	$701 - $1,010	74%
Aetna	$732 - $3,720	77%
Florida Community Care	$732	77%
Amerihealth Caritas Florida	$764	80%
Community Care Plan	$764	80%
Molina	$764	80%
Simply Healthcare	$793	83%
Blue Cross Blue Shield	$915 - $3,233	96%
Vha	$915	96%
Capital Health Plan	$971 - $2,258	102%
North Central Hospice	$971	102%
Wellcare	$971	102%
Careplus	$1,000	105%
Positive Healthcare Partners	$1,007	106%
Carelon Health	$1,030	108%
Ahf Mco Of Fl	$1,068	112%
Devoted Health Plan	$1,068	112%
Freedom Health- Inc./Optimum Healthcare- Inc.	$1,068	112%
Ghilcrest County	$1,144	120%
Levy County	$1,144	120%
Wellpath	$1,464	154%
Ambetter / Centene	$1,519	160%
Florida Health Care Plan	$1,647	173%
Uaa	$1,720	181%
Avmed	$1,797 - $1,973	189%
Northeast Fl Hospital	$1,987	209%
Health First	$3,160	333%
Prime Health Services	$3,160	333%
Cigna	$3,350	353%
Archbold Medical Center	$3,386	356%
Genex	$3,386	356%
Geha	$4,064	428%

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 $2,483.
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 UF Health Shands Hospital 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.