CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Poplar Bluff Regional Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,247
  • Cash Discount Price: $5,131
  • vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Poplar Bluff Regional Medical Center is $1,247. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,131. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.31x the Medicare baseline. Located in 3100 Oak Grove Road, Poplar Bluff, MO.
Cash / Self-Pay
$5,131

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,247

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: $5,131 (540%)
Insurance Median: $1,247 (131%)
Cash: $5,131 (540% of Medicare)
Ins. Median: $1,247 (131% 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 $250 - $4,887 26%
Veterans Eval Services $298 31%
Blue Cross Blue Shield $845 - $6,328 89%
Node Champva $939 99%
Tricare $939 99%
Medicare (plans) $982 103%
Node United Behavioral Health Mcr Adv $982 103%
Humana $991 104%
Node Hospice Non Par Agree $998 105%
Node Va $998 105%
UnitedHealthcare $998 - $13,145 105%
Node Ahs Mcr Adv $1,021 107%
Node Devoted Health Mcr Adv $1,031 109%
Node Pphp Mcr Adv $1,129 119%
Centurion Correctional $1,247 131%
Us Department Of Labor $1,247 131%
Naphcare $1,895 199%
Home State Exchange $2,494 262%
W W Wood $2,494 262%
Blue Access $3,295 347%
Self Pay $5,864 617%
Cigna $13,243 - $19,546 1394%
Evolutions Healthcare $13,316 1402%
Tyson Foods $13,438 1414%
Access Health Services, Llc $13,927 1466%
First Health $14,660 1543%
Healthlink $15,271 1607%
Parker Hannifin $17,103 1800%
Blue Traditional $18,071 1902%
Coventry Wc $19,546 2057%
Municipal Health $19,546 2057%
Multiplan $21,257 2237%
Phcs $21,257 2237%
Compresults Wc $21,990 2314%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Oak Grove Road, Poplar Bluff, MO 63901
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals