CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: M Health Fairview Woodwinds Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,160
Cash Discount Price: $1,052
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at M Health Fairview Woodwinds Hospital is $1,160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,052. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.22x the Medicare baseline. Located in 1925 Woodwinds Drive, Woodbury, MN.

Cash / Self-Pay

$1,052

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,160

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: $1,052 (111%)

Insurance Median: $1,160 (122%)

Cash: $1,052 (111% of Medicare)

Ins. Median: $1,160 (122% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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 - $908	9%
Primewest	$83 - $908	9%
Sanford Health Plan	$83 - $1,774	9%
Security Health Plan	$83 - $2,259	9%
South Country Health Alliance	$83 - $908	9%
UnitedHealthcare	$83 - $3,500	9%
Wellcare	$83 - $908	9%
Blue Cross Blue Shield	$87 - $3,418	9%
Health Partners	$88 - $2,732	9%
Ucare	$90 - $2,085	9%
Medica	$131 - $2,264	14%
Hennepin Health	$139 - $918	15%
America'S Ppo	$1,066 - $2,169	112%
First Health	$1,150 - $2,470	121%
Multiplan	$1,193 - $2,560	126%
Private Healthcare Systems	$1,193 - $2,560	126%
Wisconsin Physician Services	$1,263 - $2,711	133%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,052.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 45378.

Insurance In-Network Protection Plan

Contact your insurance company to confirm M Health Fairview Woodwinds Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 45378.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.