CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: The Women's Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $310
Cash Discount Price: $444
vs. Medicare Baseline: 0.33x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at The Women's Hospital is $310. 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 0.33x the Medicare baseline. Located in 4199 Gateway Blvd, Newburgh, IN.

Cash / Self-Pay

$444

Average discount available for prompt cash payment at this facility.

Insurance Median

$310

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: $310 (33%)

Cash: $444 (47% of Medicare)

Ins. Median: $310 (33% 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	$166 - $2,984	17%
Caresource	$166 - $815	17%
Humana	$166 - $815	17%
Iu Health	$166 - $815	17%
Meridian Health Il	$166 - $815	17%
Mhs	$166 - $815	17%
Molina Il	$166 - $815	17%
Molina Ky	$166 - $815	17%
Molina Ky Dual	$166 - $815	17%
UnitedHealthcare	$166 - $5,242	17%
Wellcare Ky	$166 - $815	17%
Aetna	$177 - $759	19%
Passport Molina Ky	$177	19%
Ambetter / Centene	$190 - $1,263	20%
Immergrun	$200 - $978	21%
Caresource Marketplace (Just4Me)	$215 - $1,222	23%
Hst	$224 - $1,222	24%
Alliance Coal	$228	24%
Allied National/Zelis - Freedom Plan	$232 - $1,996	24%
Claimdoc	$240 - $1,181	25%
Encorecombined	$244 - $488	26%
Encoreprime	$244 - $488	26%
Patoka Valley Health Care (80/20 Plan)	$248	26%
Patoka Valley Health Care (90/10 Plan)	$248	26%
Hope Trust	$265 - $1,344	28%
Noncontracted	$265 - $1,303	28%
One Care	$273	29%
Chamber Care	$275	29%
Caresource Hip	$310	33%
Caresource In	$310	33%
Mdwise Hip	$310	33%
Mhs Behavioral	$310	33%
Amish	$326 - $444	34%
Self Pay	$444	47%
Cigna	$759	80%
Claritev (Formerly Phcs/Mulitplan)	$759	80%
First Health/Coventry	$759	80%
Healthlink	$759	80%
Sagamore	$759	80%
Center Care	$761	80%

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 The Women's 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.