CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: St Joseph Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $950
  • Cash Discount Price: $926
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at St Joseph Medical Center is $950. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $926. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.00x the Medicare baseline. Located in 1000 Carondelet Dr, Kansas City, MO.
Cash / Self-Pay
$926

Average discount available for prompt cash payment at this facility.

Insurance Median
$950

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: $926 (97%)
Insurance Median: $950 (100%)
Cash: $926 (97% of Medicare)
Ins. Median: $950 (100% 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
Medicaid / KanCare $777 82%
Home State $886 - $1,483 93%
Blue Cross Blue Shield $898 - $1,715 95%
UnitedHealthcare $902 - $2,916 95%
Aetna $927 - $2,488 98%
Cigna $927 98%
Medicare (plans) $927 - $973 98%
Pace Kc (Swope Health Services) $927 98%
Tricare $927 98%
Veterans Evaluation Services $927 98%
Healthy Blue $973 - $1,034 102%
Kansas Superior $973 102%
Nhc Advantage $1,020 107%
Employer Direct Healthcare $1,298 137%
6 Degrees $1,854 195%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Carondelet Dr, Kansas City, MO 64114
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals