CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Ochsner Medical Center-Kenner

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $995
Cash Discount Price: $484
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Ochsner Medical Center-Kenner is $995. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $484. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.05x the Medicare baseline. Located in 180 West Esplanade Avenue, Kenner, LA.

Cash / Self-Pay

$484

Average discount available for prompt cash payment at this facility.

Insurance Median

$995

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: $484 (51%)

Insurance Median: $995 (105%)

Cash: $484 (51% of Medicare)

Ins. Median: $995 (105% 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
Humana	$481 - $837	51%
UnitedHealthcare	$481 - $2,680	51%
Healthy Blue (Healthy Louisiana)	$491	52%
Louisiana Healthcare Connections (Healthy Louisiana)	$491	52%
Aetna	$496 - $4,154	52%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$496	52%
Medicaid / KanCare	$677 - $711	71%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$787	83%
Blue Cross Blue Shield	$837 - $2,630	88%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$837	88%
Medicare (plans)	$837	88%
Ochsner Health Plan	$837	88%
Tricare	$837	88%
Wellcare Of Louisiana	$862	91%
Zelis	$950	100%
Claritev D/B/A Multiplan/Phcs/American Life Care	$995	105%
Healthcomp & Personify Health (Formerly Gilsbar)	$1,037	109%
First Health Network	$1,296	136%
Louisiana Workers' Compensation Corporation (Lwcc)	$1,296	136%
Mississippi Physicians Care Network	$1,296	136%
Galaxy Health Network Ppo	$1,382	145%
Galaxy Health Network Wc	$1,382	145%
Employers Health Network (Ehn)	$1,469	155%
Prime Health Services Ppo	$1,469	155%
Usa Managed Care Network	$1,469	155%
Cigna	$2,371	250%

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 $484.
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 Medical Center-Kenner 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.