CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Ascension Providence Rochester Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $893
  • Cash Discount Price: $968
  • vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Ascension Providence Rochester Hospital is $893. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $968. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.94x the Medicare baseline. Located in 1101 W University Drive, Rochester, MI.
Cash / Self-Pay
$968

Average discount available for prompt cash payment at this facility.

Insurance Median
$893

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: $968 (102%)
Insurance Median: $893 (94%)
Cash: $968 (102% of Medicare)
Ins. Median: $893 (94% 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.

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
Bluecaid $482 51%
Medicaid / KanCare $482 51%
Total Health Care Hmo $482 51%
Smarthealth $795 84%
Blue Cross Blue Shield $893 - $1,321 94%
Hap Senior Plus $893 94%
Humana $893 94%
Medicare (plans) $893 - $938 94%
Priority Health Advantage (Mcr) $893 94%
- None - $938 99%
Meridian Health Plan $1,117 118%
Blue Care Network $1,321 139%
Mva $1,697 179%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1101 W University Drive, Rochester, MI 48307
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals