CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Essentia Health Virginia

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,614
  • Cash Discount Price: $1,775
  • vs. Medicare Baseline: 1.70x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Essentia Health Virginia is $1,614. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,775. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.70x the Medicare baseline. Located in 901 9Th Street North, Virginia, MN.
Cash / Self-Pay
$1,775

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,614

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: $1,775 (187%)
Insurance Median: $1,614 (170%)
Cash: $1,775 (187% of Medicare)
Ins. Median: $1,614 (170% 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
Medica Access $650 68%
Primewest $881 93%
Advocare/Security Health $895 94%
Blue Cross Blue Shield $895 - $2,403 94%
Freedom Blue Ppo $895 94%
Healthpartners Care Msho / Mcr Adv $895 94%
Imcare Msho Pcc Prime $895 94%
Imcare Msho Ref Req $895 94%
Medica Advantage Solutions $895 94%
Medica Msho/Dual Solutions $895 94%
Medica Prime Solution Group $895 94%
Medicare (plans) $895 94%
Nd Va Administration $895 94%
Platinum Blue/Vantage Blue $895 94%
Primewest Msho $895 94%
Secure Blue Msho $895 94%
Ubh Cost Plan $895 94%
Ubh Msho $895 94%
Ucare Msho $895 94%
UnitedHealthcare $895 - $2,488 94%
Itasca Med Care $912 96%
Healthpartners Care Pmap $1,125 118%
Sanford Healthplan $1,212 - $1,614 128%
Blue Plus Pmap Pcc Prime $1,328 - $1,898 140%
Medica $1,801 - $2,002 190%
Medica Uplan $1,801 190%
Ucare $1,860 196%
Healthpartners $2,018 - $2,556 212%
Wea $2,035 - $2,177 214%
Medica Choice $2,061 217%
Security Health $2,177 229%
America'S Ppo $2,191 231%
Wps $2,346 - $2,375 247%
Aetna $2,403 253%
Cigna $2,547 - $2,556 268%
Healthpartners Pcc Prime $2,547 - $2,556 268%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 9Th Street North, Virginia, MN 55792
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals