CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Santa Rosa Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,003
  • Cash Discount Price: $2,845
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Santa Rosa Medical Center is $1,003. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,845. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.06x the Medicare baseline. Located in 6002 Berryhill Rd, Milton, FL.
Cash / Self-Pay
$2,845

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,003

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: $2,845 (299%)
Insurance Median: $1,003 (106%)
Cash: $2,845 (299% of Medicare)
Ins. Median: $1,003 (106% 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
Veterans Eval Services $322 34%
Medicaid / KanCare $637 - $739 67%
Humana $656 - $956 69%
Wellcare $669 70%
Molina $720 76%
Fl Community Care $732 77%
Tricare $923 97%
Aetna $956 - $13,658 101%
Blue Cross Blue Shield $956 - $3,708 101%
Cigna $956 - $4,286 101%
Medicare (plans) $956 101%
UnitedHealthcare $956 - $4,244 101%
Node Champva $971 102%
Node Va $971 102%
Node Wellcare Mcr Adv $1,003 106%
Geo Group $1,214 128%
Node Us Dept Of Labor $1,214 128%
Florida State Auto Insurance $1,942 204%
Prime Health Work Comp Fl $1,957 206%
Florida Workers Compensation $2,018 212%
Ambetter / Centene $2,321 244%
Oscar $2,927 308%
Self Pay $4,362 459%
Hospice Of Nw Fl $9,483 998%
Prime Health Services $15,172 1597%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6002 Berryhill Rd, Milton, FL 32570
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals