CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Lakeside Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $961
Cash Discount Price: $915
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Lakeside Medical Center is $961. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $915. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.01x the Medicare baseline. Located in 39200 Hooker Hwy, Belle Glade, FL.

Cash / Self-Pay

$915

Average discount available for prompt cash payment at this facility.

Insurance Median

$961

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: $915 (96%)

Insurance Median: $961 (101%)

Cash: $915 (96% of Medicare)

Ins. Median: $961 (101% 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
UnitedHealthcare	$67 - $915	7%
Aetna	$90 - $1,831	9%
Cigna	$674 - $1,355	71%
Geo	$869	91%
Blue Cross Blue Shield	$915 - $2,459	96%
Care Plus	$915	96%
Humana	$915	96%
Molina	$915 - $961	96%
Simply Healthcare	$915	96%
Wellpath	$915	96%
Ambetter / Centene	$961	101%
Sunshine	$961	101%
Wellcare	$961	101%
Devoted	$979	103%
Genesys	$1,007	106%
Prime Health Plan	$1,007	106%
Heritage Summit Healthcare	$1,355	143%

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 $915.
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 Lakeside Medical Center 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.