CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Rush Memorial Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $208
Cash Discount Price: $754
vs. Medicare Baseline: 0.22x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Rush Memorial Hospital is $208. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $754. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.22x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$754

Average discount available for prompt cash payment at this facility.

Insurance Median

$208

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: $754 (79%)

Insurance Median: $208 (22%)

Cash: $754 (79% of Medicare)

Ins. Median: $208 (22% 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
UnitedHealthcare	$134 - $154	14%
Caresource Mcr Adv	$154	16%
Aetna	$156 - $180	16%
Humana	$156 - $166	16%
Blue Cross Blue Shield	$159 - $519	17%
Today'S Option Mcr Adv-All Plans	$159	17%
Viant Beech St Mcr Adv	$159	17%
My True Advantage - All Plans	$162	17%
Consumers Life Ins-All Plans	$180	19%
Caresource Marketplace-All Other Plans	$208	22%
Phcs-All Plans	$246	26%
Cigna	$502	53%
Health Net	$502	53%
Multiplan-All Plans	$517	54%
Encore Health Services-All Plans	$563	59%
Siho-All Plans	$563	59%
Coventry/First Health-All Plans	$703	74%

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 $754.
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 Rush Memorial 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.