CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Gibson General 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 Gibson General 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 1808 Sherman Drive, Princeton, 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
Chambercare	$140 - $2,154	15%
Aetna	$166 - $759	17%
Blue Cross Blue Shield	$166 - $328	17%
Caresource Just For Me	$166	17%
Medicare (plans)	$166	17%
Meridiancomplete (Il)	$166	17%
Mytruadvantage	$166	17%
UnitedHealthcare	$166 - $2,060	17%
Va Ccn	$166	17%
Medicaid / KanCare	$179	19%
Meridiancare (Il)	$179	19%
Meridianhealth (Il)	$179	19%
Ambetter / Centene	$207	22%
Caresource In Marketplace	$215	23%
Alliance Coal	$232	24%
Claimdoc	$232	24%
Hopetrust	$248	26%
Hstechnology	$248	26%
Noncontracted	$265	28%
Deaconess Onecare	$273 - $1,975	29%
Caresource	$310	33%
Mdwise Plans	$310	33%
Mhs	$310	33%
Ky Racing Health & Welfare Fund	$444	47%
Self-Pay	$444	47%
Encircle/Encore Combined	$488 - $2,109	51%
Encircle/Encore Prime	$488 - $1,975	51%
Cigna	$759	80%
First Health	$759	80%
Healthlink Hmo	$759	80%
Healthlink Ppo	$759	80%
Sagamore (Ppo, Oap-Open Access Plus, Epo, Choice Fund Oap+)	$759	80%
Gibson County Sheriff	$1,079	114%
Integrated Health	$1,142	120%
Principal Health Care	$1,142	120%

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 Gibson General 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.