CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Deaconess Illinois Crossroads

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $950
Cash Discount Price: $444
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Deaconess Illinois Crossroads is $950. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $444. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.00x the Medicare baseline. Located in 8 Doctors Park Rd, Mount Vernon, IL.

Cash / Self-Pay

$444

Average discount available for prompt cash payment at this facility.

Insurance Median

$950

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: $444 (47%)

Insurance Median: $950 (100%)

Cash: $444 (47% of Medicare)

Ins. Median: $950 (100% 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
Aetna	$175 - $1,003	18%
Blue Cross Blue Shield	$175 - $950	18%
Humana	$175 - $990	18%
Meridian Health Plan	$175 - $950	18%
Molina Healthcare Of Illinois	$175 - $960	18%
Mytru Advantage	$175 - $950	18%
Umwa	$175 - $950	18%
UnitedHealthcare	$175 - $950	18%
Wellcare	$175 - $950	18%
Healthlink	$217 - $226	23%
Alliance Coal	$241 - $1,568	25%
Alter-Net Medical Services, Inc.	$279 - $2,709	29%
Noncontracted	$279 - $1,521	29%
Deaconess Onecare	$358 - $2,186	38%
Self-Pay	$444	47%
Cigna	$494	52%
Prime Health Services	$952	100%
Care Improvement Plus	$969	102%
Guardian Resources, Inc.	$1,066	112%
Healthcare'S Finest Network (Hfn)	$1,079	114%
Medicalcontrol Network Solutions	$1,079	114%
National Provider Network	$1,079	114%
Three Rivers Provider Network	$1,104	116%
Beech Street	$1,117	118%
Encore Combined	$2,186	230%
Encore Prime/Elite/Elite +	$2,186	230%
Hope Trust	$2,709	285%

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 $444.
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 Deaconess Illinois Crossroads 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.