CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: M Health Fairview Ridges Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $920
  • Cash Discount Price: $1,115
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at M Health Fairview Ridges Hospital is $920. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,115. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.97x the Medicare baseline. Located in 201 East Nicollet Boulevard, Burnsville, MN.
Cash / Self-Pay
$1,115

Average discount available for prompt cash payment at this facility.

Insurance Median
$920

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: $1,115 (117%)
Insurance Median: $920 (97%)
Cash: $1,115 (117% of Medicare)
Ins. Median: $920 (97% 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
Itasca Medical Care $83 - $887 9%
Primewest $83 - $887 9%
Sanford Health Plan $83 - $1,774 9%
Security Health Plan $83 - $2,259 9%
South Country Health Alliance $83 - $887 9%
UnitedHealthcare $83 - $3,500 9%
Wellcare $83 - $887 9%
Blue Cross Blue Shield $87 - $3,418 9%
Health Partners $88 - $2,732 9%
Ucare $90 - $2,038 9%
Medica $131 - $2,264 14%
Hennepin Health $139 - $918 15%
America'S Ppo $525 - $2,169 55%
First Health $566 - $2,470 60%
Multiplan $587 - $2,560 62%
Private Healthcare Systems $587 - $2,560 62%
Wisconsin Physician Services $622 - $2,711 65%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 East Nicollet Boulevard, Burnsville, MN 55337
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals