CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Cleveland Clinic Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $400
Cash Discount Price: $911
vs. Medicare Baseline: 0.42x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Cleveland Clinic Hospital is $400. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $911. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.42x the Medicare baseline. Located in 3100 Weston Rd, Weston, FL.

Cash / Self-Pay

$911

Average discount available for prompt cash payment at this facility.

Insurance Median

$400

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: $911 (96%)

Insurance Median: $400 (42%)

Cash: $911 (96% of Medicare)

Ins. Median: $400 (42% 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
Blue Cross Blue Shield	$56 - $2,890	6%
Avmed	$94 - $1,977	10%
Doctors Health Plan	$94 - $915	10%
United	$94 - $2,932	10%
Wellcare	$94 - $915	10%
Independent Living Systems	$99 - $961	10%
Clear Spring Health	$102 - $249	11%
Aetna	$117 - $3,109	12%
UnitedHealthcare	$246	26%
Medicaid / KanCare	$259	27%
Cigna	$273 - $1,312	29%
Maritime	$296 - $2,352	31%
Multiplan	$296 - $3,998	31%
Clarity Health	$385 - $3,057	41%
The Legacy Companies	$385 - $3,057	41%
Consociate Health	$444 - $1,236	47%
Humana	$915	96%
Devoted Health	$1,007	106%
Bmi	$2,587	272%

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 $911.
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 Cleveland Clinic 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.