CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Memorial Hospital and Health Care Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $328
Cash Discount Price: $444
vs. Medicare Baseline: 0.35x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Memorial Hospital and Health Care Center is $328. 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 0.35x the Medicare baseline. Located in 800 W 9Th St, Jasper, IN.

Cash / Self-Pay

$444

Average discount available for prompt cash payment at this facility.

Insurance Median

$328

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: $328 (35%)

Cash: $444 (47% of Medicare)

Ins. Median: $328 (35% 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	$166 - $955	17%
Blue Cross Blue Shield	$166 - $955	17%
Caresource In Marketplace	$166 - $1,194	17%
Humana	$166 - $955	17%
Tricare	$166 - $812	17%
Mdwise	$167	18%
Mhs Hoosier Care Connect	$167	18%
Immergrun	$199 - $1,146	21%
Ambetter / Centene	$215 - $1,242	23%
Noncontracted	$265 - $1,528	28%
Onecare	$273 - $2,107	29%
Siho	$273	29%
Chamber Care	$280	29%
Cigna	$292	31%
Sagamore	$292	31%
UnitedHealthcare	$331 - $2,865	35%
Patoka Valley	$467	49%
Encore	$636	67%
Encore Elite +	$636 - $2,292	67%

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 Memorial Hospital and Health Care Center 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.