CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Essentia Health St Joseph's Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,276
  • Cash Discount Price: $1,903
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Essentia Health St Joseph's Medical Center is $1,276. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,903. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.34x the Medicare baseline. Located in 523 North 3Rd Street, Brainerd, MN.
Cash / Self-Pay
$1,903

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,276

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: $1,903 (200%)
Insurance Median: $1,276 (134%)
Cash: $1,903 (200% of Medicare)
Ins. Median: $1,276 (134% 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%
Medica Access $893 94%
Itasca Med Care $912 96%
Advocare/Security Health $979 103%
Blue Cross Blue Shield $979 - $3,379 103%
Freedom Blue Ppo $979 103%
Healthpartners Care Msho / Mcr Adv $979 103%
Imcare Msho Pcc Prime $979 103%
Imcare Msho Ref Req $979 103%
Medica Advantage Solutions $979 103%
Medica Msho/Dual Solutions $979 103%
Medica Prime Solution Group $979 103%
Medicare (plans) $979 103%
Nd Va Administration $979 103%
Platinum Blue/Vantage Blue $979 103%
Primewest Msho $979 103%
Secure Blue Msho $979 103%
Ubh Cost Plan $979 103%
Ubh Msho $979 103%
Ucare Msho $979 103%
UnitedHealthcare $979 - $2,151 103%
Sanford Health Plan $1,212 - $1,276 128%
Healthpartners Care Pmap $1,216 128%
Blue Plus Pmap Pcc Prime $1,272 - $3,150 134%
Medica $1,798 - $1,999 189%
Medica Uplan $1,798 189%
Ucare $1,860 196%
Wea $2,035 - $2,177 214%
Medica Choice $2,058 217%
Cigna $2,078 219%
Healthpartners $2,078 219%
Healthpartners Pcc Prime $2,078 219%
America'S Ppo $2,191 231%
Wps $2,346 - $2,375 247%
Aetna $2,403 253%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 523 North 3Rd Street, Brainerd, MN 56401
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals