CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Barnes Jewish Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $2,881
Cash Discount Price: $3,215
vs. Medicare Baseline: 3.03x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Barnes Jewish Hospital is $2,881. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,215. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 3.03x the Medicare baseline. Located in One Barnes-Jewish Hospital Plaza, Saint Louis, MO.

Cash / Self-Pay

$3,215

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,881

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: $3,215 (338%)

Insurance Median: $2,881 (303%)

Cash: $3,215 (338% of Medicare)

Ins. Median: $2,881 (303% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 303% of the Medicare baseline (a markup of 203%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$931 - $8,528	98%
Blue Cross Blue Shield	$931 - $3,424	98%
Essence Healthcare [221]	$931 - $3,163	98%
Humana	$931 - $8,188	98%
UnitedHealthcare	$931 - $3,163	98%
Cox Health [757]	$978 - $3,321	103%
Devoted Health Plan [847]	$978 - $3,321	103%
Medica [662]	$978 - $3,321	103%
Healthscope Benefits [258]	$1,148 - $2,643	121%
Cox Health Systems Insurance Company [220]	$1,403	148%
Health Alliance [224]	$1,403	148%
Allied Benefits [498]	$1,480 - $8,528	156%
Hope Trust [806]	$1,480	156%
Healthcare Sol Mercy [609]	$1,913	201%
Med-Pay [480]	$1,913	201%
Medica [661]	$2,041	215%
Phcs [244]	$2,041	215%
Cigna	$2,621 - $9,994	276%
Consociate [478]	$2,740 - $5,505	288%
Sarah Bush Lincoln [636]	$2,740 - $5,505	288%
Coresource [497]	$3,209 - $8,528	338%
Fmh Benefit Service Inc [222]	$3,209 - $8,528	338%
Mail Handlers [495]	$3,209 - $8,528	338%
Apwu Health Plan [216]	$4,641 - $9,994	488%
Nalc Health Benefit Plan [242]	$4,641 - $9,994	488%
Priority Health [648]	$4,641 - $9,994	488%

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 $3,215.
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 Barnes Jewish 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.