CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Ochsner American Legion Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $829
Cash Discount Price: $610
vs. Medicare Baseline: 0.87x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Ochsner American Legion Hospital is $829. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $610. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.87x the Medicare baseline. Located in 1634 Elton Road, Jennings, LA.

Cash / Self-Pay

$610

Average discount available for prompt cash payment at this facility.

Insurance Median

$829

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: $610 (64%)

Insurance Median: $829 (87%)

Cash: $610 (64% of Medicare)

Ins. Median: $829 (87% 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	$468 - $1,732	49%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$468	49%
Healthy Blue (Healthy Louisiana)	$468	49%
Humana	$468 - $829	49%
Louisiana Healthcare Connections (Healthy Louisiana)	$468	49%
UnitedHealthcare	$468 - $1,076	49%
Verity Commercial And First Choice Network	$499	53%
Blue Cross Blue Shield	$829 - $1,619	87%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$829	87%
Medicare (plans)	$829	87%
Ochsner Health Plan	$829	87%
Tricare	$829	87%
Wellcare Of Louisiana	$829	87%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$854	90%
Louisiana Workers' Compensation Corporation (Lwcc)	$908 - $1,452	96%
Cigna	$1,300	137%
Zelis	$1,345	142%
Provider Network Of America	$1,409	148%
Healthcomp & Personify Health (Formerly Gilsbar)	$1,524	160%

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 $610.
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 American Legion 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.