CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Rockcastle County Hospital, Inc.

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $654
  • Cash Discount Price: $611
  • vs. Medicare Baseline: 0.69x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Rockcastle County Hospital, Inc. is $654. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $611. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.69x the Medicare baseline. Located in 145 Newcomb Avenue, Mount Vernon, KY.
Cash / Self-Pay
$611

Average discount available for prompt cash payment at this facility.

Insurance Median
$654

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: $611 (64%)
Insurance Median: $654 (69%)
Cash: $611 (64% of Medicare)
Ins. Median: $654 (69% 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
Caresource Mcaid $177 19%
Coventry Mcaid-All Plans $177 19%
Medicaid / KanCare $177 19%
Molina Mcaid $177 19%
UnitedHealthcare $177 - $350 19%
Passport Hp Hmo - All Plans $217 23%
Humana $322 - $873 34%
Blue Cross Blue Shield $547 - $873 58%
Tricare $654 69%
Multiplan-All Plans $683 72%
Prime Health Services-All Plans $683 72%
Integrated Hp-All Plans $716 75%
Corvel - All Plans $724 76%
Center Care-All Plans $764 80%
Cigna $780 82%
Caresource Mcr Adv-All Other Plans $873 92%
Molina Marketplace - All Other Plans $873 92%
Molina Mcr Adv $873 92%
Signature Mcr Adv-All Plans $873 92%
Wellcare Mcr Adv-All Other Plans $873 92%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 145 Newcomb Avenue, Mount Vernon, KY 40456
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals