CMS Price Transparency Data
Colonoscopy (diagnostic)
Facility: Mercy Hospital Springfield
Billing Code: 45378 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 45378
- Insurance Median: $980
- Cash Discount Price: $2,179
- vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Mercy Hospital Springfield is $980. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,179. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.03x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$2,179
Average discount available for prompt cash payment at this facility.
Insurance Median
$980
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: $2,179 (229%)
Insurance Median: $980 (103%)
Cash: $2,179 (229% of Medicare)
Ins. Median: $980 (103% 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.
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 | $166 - $2,660 | 17% |
| Medicaid / KanCare | $250 - $777 | 26% |
| Evolutions Health Care Contracted [320124] | $433 - $1,103 | 46% |
| Federal Medical Center Contracted [320127] | $469 - $1,471 | 49% |
| Benefit Management Contracted [320052] | $485 - $980 | 51% |
| Health Systems Inc Contracted [320174] | $485 - $980 | 51% |
| Insurance System Inc Contracted [320465] | $485 - $980 | 51% |
| UnitedHealthcare | $777 - $1,887 | 82% |
| Aetna | $810 - $1,226 | 85% |
| Centurion Of Missouri [20459] | $810 | 85% |
| Champva [20065] | $810 | 85% |
| Cherokee Nation Health Serv Contracted [320066] | $810 | 85% |
| Cigna | $810 - $1,887 | 85% |
| Cross Timbers Hospice [20098] | $810 | 85% |
| Dept Of Veteran Affairs Contracted [320106] | $810 | 85% |
| Elara Caring Aspire Hospice [20433] | $810 | 85% |
| Globalhealth Contracted [320145] | $810 | 85% |
| Halo Hcr Inc Hospice Contracted [320432] | $810 | 85% |
| Halo Hcr Inc Hospice [20432] | $810 | 85% |
| Humana | $810 - $1,667 | 85% |
| Indian Health Service Contracted [320198] | $810 | 85% |
| Indian Health Service [20198] | $810 | 85% |
| Kindful Hospice Contracted [320434] | $810 | 85% |
| Kindful Hospice [20434] | $810 | 85% |
| Medicare (plans) | $810 - $851 | 85% |
| Mercy Hospice Okc [20252] | $810 | 85% |
| Mercy Mgd Behavioral Health Contracted [320259] | $810 | 85% |
| Mercy Rehab Hospital Contracted [320260] | $810 | 85% |
| Pace Of The Ozarks Contracted [320518] | $810 | 85% |
| Qual Choice Contracted [320325] | $810 | 85% |
| Tricare | $810 | 85% |
| Mercy Benefit Admin Contracted [320251] | $827 - $1,471 | 87% |
| Point C Contracted [320238] | $846 - $1,838 | 89% |
| Point C [20238] | $862 - $1,103 | 91% |
| Provider Partners Health Plans Contracted [320450] | $893 | 94% |
| 90 Degree Benefits Contracted [320436] | $909 - $1,471 | 96% |
| Aither Health Contracted [320449] | $909 - $1,397 | 96% |
| Auxiant Contracted [320462] | $909 - $1,593 | 96% |
| Ebms Contracted [320493] | $909 - $1,397 | 96% |
| Edison Health Solutions Contracted [320502] | $909 - $1,397 | 96% |
| Healthlink Contracted [320179] | $909 - $1,397 | 96% |
| Imagine 360 Contracted [320494] | $909 - $1,397 | 96% |
| Reflect Health Contracted [320492] | $909 - $1,397 | 96% |
| Show-Me Health Administrators Contracted [320483] | $909 - $1,471 | 96% |
| Yuzu Health Contracted [320521] | $909 - $1,397 | 96% |
| Healthscope Contracted [320182] | $1,032 | 109% |
| Administrative Payor Contracted [320005] | $1,103 - $1,226 | 116% |
| Medical Destinations Contracted [320242] | $1,226 | 129% |
| Workers Comp [20426] | $1,226 - $2,083 | 129% |
| United Medical Resources Contracted [320454] | $1,275 - $2,307 | 134% |
| Centivo Contracted [320505] | $1,363 | 143% |
| First Health Contracted [320128] | $1,373 | 145% |
| Providrs Care Network Contracted [320484] | $1,471 - $1,686 | 155% |
| Multiplan Contracted [320270] | $1,671 - $1,887 | 176% |
| Private Health Care Systems Contracted [320320] | $1,671 - $1,887 | 176% |
| Compcare Of The Ozarks Contracted [320437] | $1,936 | 204% |
| American Healthcare Alliance Contracted [320020] | $1,961 | 206% |
| Qual Choice Contracted [320324] | $1,961 | 206% |
| Municipal Health Plan Contracted [320271] | $1,985 | 209% |
| Usa Managed Care Org Contracted [320429] | $2,157 | 227% |
| Ppo Plus Contracted [320310] | $2,206 | 232% |