CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Essentia Health St Mary's Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,414
  • Cash Discount Price: $1,866
  • vs. Medicare Baseline: 1.49x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Essentia Health St Mary's Medical Center is $1,414. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,866. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.49x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$1,866

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,414

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: $1,866 (196%)
Insurance Median: $1,414 (149%)
Cash: $1,866 (196% of Medicare)
Ins. Median: $1,414 (149% 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
Primewest $881 93%
Itasca Med Care $912 96%
Advocare/Security Health $914 96%
Blue Cross Blue Shield $914 - $2,149 96%
Freedom Blue Ppo $914 96%
Healthpartners Care Msho / Mcr Adv $914 96%
Imcare Msho (Ref Req) $914 96%
Imcare Msho Pcc Prime $914 96%
Imcare Msho Ref Req $914 96%
Medica Advantage Solutions $914 96%
Medica Msho/Dual Solutions $914 96%
Medica Prime Solution Group $914 96%
Medicare (plans) $914 96%
Nd Va Administration $914 96%
Platinum Blue / Vantage Blue $914 96%
Primewest Msho $914 96%
Secure Blue Msho $914 96%
Ubh Cost Plan $914 96%
Ubh Msho $914 96%
Ucare Msho $914 96%
UnitedHealthcare $914 - $2,069 96%
Medica Access $936 99%
Healthpartners Care Pmap $1,125 118%
Sanford Health Plan $1,212 - $1,614 128%
Blue Plus Pmap Pcc Prime $1,248 - $1,414 131%
Medica $1,563 - $1,606 165%
Medica Uplan $1,563 165%
Healthpartners $1,693 - $2,021 178%
Medica Choice $1,727 182%
Ucare $1,860 196%
Cigna $2,021 213%
Healthpartners Pcc Prime $2,021 213%
Wea $2,035 - $2,177 214%
Security Health $2,177 229%
America'S Ppo $2,191 231%
Wps $2,346 - $2,375 247%
Aetna $2,403 253%
Healthscope Benefits $2,403 253%
Healtheos $2,431 256%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 402 East Second Street, Duluth, MN 55805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals