CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Essentia Health St Marys - Detroit Lakes

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,614
  • Cash Discount Price: $1,815
  • vs. Medicare Baseline: 1.70x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Essentia Health St Marys - Detroit Lakes is $1,614. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,815. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.70x the Medicare baseline. Located in 1027 Washington Ave, Detroit Lakes, MN.
Cash / Self-Pay
$1,815

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: $1,815 (191%)
Insurance Median: $1,614 (170%)
Cash: $1,815 (191% 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
Blue Cross Blue Shield $612 - $2,149 64%
Primewest $881 93%
Itasca Med Care $912 96%
Advocare/Security Health $958 101%
Freedom Blue Ppo $958 101%
Healthpartners Care Msho / Mcr Adv $958 101%
Imcare Msho Pcc Prime $958 101%
Imcare Msho Ref Req $958 101%
Medica Advantage Solutions $958 101%
Medica Msho/Dual Solutions $958 101%
Medica Prime Solution Group $958 101%
Medicare (plans) $958 101%
Nd Va Administration $958 101%
Platinum Blue/Vantage Blue $958 101%
Primewest Msho $958 101%
Secure Blue Msho $958 101%
Ubh Cost Plan $958 101%
Ubh Msho $958 101%
Ucare Msho $958 101%
UnitedHealthcare $958 - $2,375 101%
Healthpartners Care Pmap $1,100 116%
Sanford Healthplan $1,212 - $1,614 128%
Medica Uplan $1,798 189%
Ucare $1,860 196%
Healthpartners $1,900 - $2,075 200%
Medica $1,973 - $2,194 208%
Wea $2,035 - $2,177 214%
Cigna $2,075 218%
Healthpartners Pcc Prime $2,075 218%
America'S Ppo $2,191 231%
Medica Choice $2,259 238%
Wps $2,346 - $2,375 247%
Aetna $2,403 253%
Healtheos $2,431 256%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1027 Washington Ave, Detroit Lakes, MN 56501
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals