CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Ochsner University Hospital and Clinics

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $481
Cash Discount Price: $402
vs. Medicare Baseline: 0.51x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Ochsner University Hospital and Clinics is $481. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $402. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.51x the Medicare baseline. Located in 2390 West Congress, Lafayette, LA.

Cash / Self-Pay

$402

Average discount available for prompt cash payment at this facility.

Insurance Median

$481

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: $402 (42%)

Insurance Median: $481 (51%)

Cash: $402 (42% of Medicare)

Ins. Median: $481 (51% 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
Aetna	$170 - $918	18%
Blue Cross Blue Shield	$170 - $1,351	18%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$170 - $829	18%
Medicare (plans)	$170 - $829	18%
Ochsner Health Plan	$170 - $829	18%
UnitedHealthcare	$170 - $1,914	18%
Wellcare Of Louisiana	$170 - $870	18%
Tricare	$174 - $829	18%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$175 - $854	18%
Verity Commercial And First Choice Network	$189 - $541	20%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$244 - $481	26%
Healthy Blue (Healthy Louisiana)	$244 - $481	26%
Humana	$244 - $481	26%
Louisiana Healthcare Connections (Healthy Louisiana)	$244 - $481	26%
Cigna	$345 - $1,576	36%
Zelis	$433 - $2,106	46%

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 $402.
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 Ochsner University Hospital and Clinics 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.