CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: HCA Florida Gulf Coast Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $3,044
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 3.20x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at HCA Florida Gulf Coast Hospital is $3,044. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 3.20x the Medicare baseline. Located in 449 W 23Rd St, Panama City, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,044

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%)
Insurance Median: $3,044 (320%)
Ins. Median: $3,044 (320% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 320% of the Medicare baseline (a markup of 220%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Corvel Corporation $1,142 - $1,858 120%
Prime Health $1,166 - $1,897 123%
Careworks (Rockport Community) $1,202 - $1,956 127%
Molina Healthcare $1,950 - $3,242 205%
Simply $2,250 237%
Blue Cross Blue Shield $2,326 - $3,078 245%
Simply Healthcare $3,440 362%
Oscar $3,743 394%
Evolutions $5,700 600%
Avmed $8,168 - $8,971 860%
Ultimate Health Plan $12,500 1316%
United $13,000 1368%
Cigna $17,004 - $40,673 1790%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 449 W 23Rd St, Panama City, FL 32405
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals