CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Columbus Regional Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $955
Cash Discount Price: $5,863
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Columbus Regional Hospital is $955. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,863. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.01x the Medicare baseline. Located in 2400 E 17Th St, Columbus, IN.

Cash / Self-Pay

$5,863

Average discount available for prompt cash payment at this facility.

Insurance Median

$955

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: $5,863 (617%)

Insurance Median: $955 (101%)

Cash: $5,863 (617% of Medicare)

Ins. Median: $955 (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
Blue Cross Blue Shield	$153 - $955	16%
Managed Health Services	$153	16%
Mdwise	$153	16%
Medicaid / KanCare	$153	16%
Aetna	$955	101%
Ambetter / Centene	$955	101%
Caresource Commercial	$955	101%
Humana	$955	101%
Medicare (plans)	$955	101%
UnitedHealthcare	$955	101%

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 $5,863.
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 Columbus Regional 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.