CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Holland Community Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $326
Cash Discount Price: $210
vs. Medicare Baseline: 0.34x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Holland Community Hospital is $326. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $210. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.34x the Medicare baseline. Located in 602 Michigan Ave, Holland, MI.

Cash / Self-Pay

$210

Average discount available for prompt cash payment at this facility.

Insurance Median

$326

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: $210 (22%)

Insurance Median: $326 (34%)

Cash: $210 (22% of Medicare)

Ins. Median: $326 (34% 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
UnitedHealthcare	$50 - $510	5%
Nomi Health - All Plans	$84	9%
Life Circles-All Plans	$154	16%
Health Alliance Mcr Adv	$163	17%
Ph Mcr Adv	$163	17%
Va Ccn - All Plans	$163	17%
Aetna	$167 - $510	18%
Longevity Health Plan-All Plans	$176	19%
First Health-All Plans	$211	22%
Benefit Source Inc-All Plans	$280	29%
Blue Cross Blue Shield	$292	31%
Multiplan - All Plans	$315	33%
Cigna	$319	34%
Priority Health - All Other Plans	$333	35%
Sisco-All Other Plans	$418	44%
Asr - All Plans	$467	49%
Health Alliance Ahl - All Other Plans	$467	49%
Health Alliance Hmo	$467	49%
Blue Care Network - All Plans	$504	53%
Cofinity -All Plans	$510	54%
Meridian Mcaid Profee Only-All Plans	$510	54%
Molina Mcaid - All Plans	$510	54%
Ph Mcaid	$510	54%
Sisco Epi	$1,016	107%

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 $210.
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 Holland Community 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.