CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Morris Hospital & Healthcare Centers

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $997
Cash Discount Price: $301
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Morris Hospital & Healthcare Centers is $997. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $301. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.05x the Medicare baseline. Located in 150 W High St, Morris, IL.

Cash / Self-Pay

$301

Average discount available for prompt cash payment at this facility.

Insurance Median

$997

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: $301 (32%)

Insurance Median: $997 (105%)

Cash: $301 (32% of Medicare)

Ins. Median: $997 (105% 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
Cigna	$62	7%
Capp Care Ppo-Oth	$488	51%
Blue Cross Blue Shield	$541 - $601	57%
Caterpillar - All Plans	$563	59%
Aetna	$769 - $1,016	81%
Ambetter / Centene	$876	92%
UnitedHealthcare	$914 - $997	96%
Choicecare Hum Mcr Ppo	$997	105%
Choicecare Hum Othr - All Other Plans	$1,002	105%
Multiplan - All Other Plans	$1,002	105%
Multiplan Prime Ntwrk	$1,002	105%
Health Alliance Mcr Adv	$1,026	108%
Health Alliance - All Other Plans	$1,064	112%
Hfn All Plans - All Plans	$1,064	112%

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 $301.
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 Morris Hospital & Healthcare Centers 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.