CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Mosaic Life Care at St Joseph

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,497
Cash Discount Price: $1,626
vs. Medicare Baseline: 1.58x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Mosaic Life Care at St Joseph is $1,497. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,626. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.58x the Medicare baseline. Located in 5325 Faraon Street, Saint Joseph, MO.

Cash / Self-Pay

$1,626

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,497

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: $1,626 (171%)

Insurance Median: $1,497 (158%)

Cash: $1,626 (171% of Medicare)

Ins. Median: $1,497 (158% 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
Blue Cross Blue Shield	$68 - $1,736	7%
UnitedHealthcare	$119 - $2,820	13%
Aetna	$169 - $1,654	18%
Amerigroup Of Iowa	$209	22%
Iowa Total Care	$209	22%
Molina Of Iowa	$209	22%
Medicaid / KanCare	$296 - $307	31%
Ambetter / Centene	$321 - $1,746	34%
Centurion	$474 - $1,400	50%
Geha Shared Services	$550 - $1,624	58%
Freedom Select Healthlink	$581 - $1,717	61%
Healthlink Open Access	$581 - $1,717	61%
Preferred Health Professional	$581 - $1,717	61%
Sisco	$581 - $1,717	61%
Cigna	$596 - $1,760	63%
Multiplan	$1,240 - $1,800	131%
Home State Of Missouri	$2,900	305%
Healthy Blue Of Missouri	$3,560	375%

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 $1,626.
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 Mosaic Life Care at St Joseph 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.