CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Kosciusko Community Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $419
  • Cash Discount Price: $198
  • vs. Medicare Baseline: 0.44x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Kosciusko Community Hospital is $419. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $198. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.44x the Medicare baseline. Located in 2101 E Dubois Dr, Warsaw, IN.
Cash / Self-Pay
$198

Average discount available for prompt cash payment at this facility.

Insurance Median
$419

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: $198 (21%)
Insurance Median: $419 (44%)
Cash: $198 (21% of Medicare)
Ins. Median: $419 (44% 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.

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
Lutheran Preferred Network $50 - $7,393 5%
Physicians Health Plan $58 - $4,258 6%
Php Freedom Network $61 - $3,569 6%
Self Pay $62 - $1,941 7%
UnitedHealthcare $62 - $4,861 7%
Encore $63 - $3,696 7%
Trma Inc $63 - $1,121 7%
Aetna $65 - $4,916 7%
Connecticut General Life Insurance Company $93 - $5,443 10%
Cigna $100 - $5,840 11%
Amish Aid $104 - $1,941 11%
First Health Network $118 - $6,930 12%
Prime Health Services $118 - $6,930 12%
Advantage Health $131 - $7,670 14%
Private Healthcare Systems $136 - $7,947 14%
Sagamore $139 - $8,686 15%
Encore Health Network $147 - $8,594 15%
One Call Care Diagnostics Wc $154 16%
Veterans Eval Services $158 - $304 17%
Tricare $935 98%
Department Of Veterans Affairs $984 104%
Blue Cross Blue Shield $1,037 - $4,043 109%
Humana $1,037 - $2,274 109%
Medicare (plans) $1,037 109%
Mhs $1,037 - $2,274 109%
Iu Health $1,054 111%
Node Non Par Hospice Agree $1,054 111%
Node Va $1,054 111%
Node Devoted Health Mcr Adv $1,058 111%
In Dept Of Correction $1,096 115%
Node Pphp Mcr Adv $1,106 116%
Us Department Of Labor $1,317 139%
Lutheran Advanced Network $1,581 166%
Lutheran Preferred $1,581 - $2,108 166%
Align In Work Comp $1,686 177%
One Call Work Comp $1,686 177%
Caresource $1,749 - $2,274 184%
Encore Work Comp In $1,897 200%
Managed Health Services Exchange $2,108 222%
Workers Comp $2,108 222%
Managed Health Services $2,274 239%
Medicaid / KanCare $2,274 239%
Encore Kba Epo $2,529 266%
Encore Kba Ppo $3,161 333%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2101 E Dubois Dr, Warsaw, IN 46580
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals