CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Citizens Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $468
Cash Discount Price: $807
vs. Medicare Baseline: 0.49x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Citizens Medical Center is $468. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $807. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.49x the Medicare baseline. Located in 7939 U S Hwy 165 South, Columbia, LA.

Cash / Self-Pay

$807

Average discount available for prompt cash payment at this facility.

Insurance Median

$468

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: $807 (85%)

Insurance Median: $468 (49%)

Cash: $807 (85% of Medicare)

Ins. Median: $468 (49% 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
Medicare (plans)	$167	18%
Peoples Health	$167	18%
UnitedHealthcare	$167 - $468	18%
Aetna	$468	49%
Amerihealth Caritas	$468	49%
Healthy Blue	$468	49%
Louisiana Health Care Connections	$468	49%
Medicaid / KanCare	$468	49%

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 $807.
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 Citizens Medical Center 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.