CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Fairview Bethesda Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,547
Cash Discount Price: $1,024
vs. Medicare Baseline: 1.63x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Fairview Bethesda Hospital is $1,547. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,024. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.63x the Medicare baseline. Located in 45 10Th St W, Saint Paul, MN.

Cash / Self-Pay

$1,024

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,547

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: $1,024 (108%)

Insurance Median: $1,547 (163%)

Cash: $1,024 (108% of Medicare)

Ins. Median: $1,547 (163% 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
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 - $1,720	9%
Wellcare	$83 - $908	9%
Blue Cross Blue Shield	$87 - $1,775	9%
Health Partners	$88 - $2,346	9%
Ucare	$90 - $2,085	9%
Itasca Medical Care	$123 - $908	13%
Medica	$131 - $2,178	14%
Hennepin Health	$139 - $918	15%
America'S Ppo	$1,331 - $2,169	140%
First Health	$2,095 - $2,470	221%
Multiplan	$2,171 - $2,560	229%
Private Healthcare Systems	$2,171 - $2,560	229%
Wisconsin Physician Services	$2,299 - $2,711	242%

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 $1,024.
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 Fairview Bethesda 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.