CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Lakewood Health System

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $366
Cash Discount Price: $1,084
vs. Medicare Baseline: 0.39x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Lakewood Health System is $366. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,084. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.39x the Medicare baseline. Located in 49725 County Road 83, Staples, MN.

Cash / Self-Pay

$1,084

Average discount available for prompt cash payment at this facility.

Insurance Median

$366

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: $1,084 (114%)

Insurance Median: $366 (39%)

Cash: $1,084 (114% of Medicare)

Ins. Median: $366 (39% 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
Ucare Msho/Special Needs	$115 - $1,194	12%
Blue Cross Blue Shield	$156 - $3,487	16%
Humana	$156 - $1,170	16%
Ucare Mcr Adv	$156 - $1,194	16%
UnitedHealthcare	$156 - $2,578	16%
Medica Msho/Mcr Adv	$175 - $1,159	18%
Ucare Individual/Family - All Other Plans	$250 - $1,333	26%
Medica Choice Care	$293 - $1,414	31%
Medica Choice/Focus/Ifb/Mhps - All Other Plans	$300 - $2,593	32%
Preferred One Hmo	$346 - $2,752	36%
Preferred One Ppo - All Other Plans	$366 - $2,752	39%
Health Partners - All Plans	$439 - $2,723	46%

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 $1,084.
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 Lakewood Health System 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.