CMS Price Transparency Data
Colonoscopy (diagnostic)
Facility: Mercy Hospital Stoddard
Billing Code: 45378 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 45378
- Insurance Median: $1,698
- Cash Discount Price: $3,854
- vs. Medicare Baseline: 1.79x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Mercy Hospital Stoddard is $1,698. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,854. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.79x the Medicare baseline. Located in 1200 N One Mile Rd, Dexter, MO.
Cash / Self-Pay
$3,854
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,698
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: $3,854 (406%)
Insurance Median: $1,698 (179%)
Cash: $3,854 (406% of Medicare)
Ins. Median: $1,698 (179% 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
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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 - $5,770 | 17% |
| Indian Health Service Contracted [320198] | $166 | 17% |
| Medicaid / KanCare | $509 - $3,395 | 54% |
| Acentra Health Contracted [320527] | $810 | 85% |
| Aetna | $810 - $2,546 | 85% |
| Cross Timbers Hospice [20098] | $810 | 85% |
| Dept Of Veteran Affairs Contracted [320106] | $810 | 85% |
| Elara Caring Aspire Hospice Contracted [320433] | $810 | 85% |
| Elara Caring Aspire Hospice [20433] | $810 | 85% |
| Halo Hcr Inc Hospice Contracted [320432] | $810 | 85% |
| Halo Hcr Inc Hospice [20432] | $810 | 85% |
| Humana | $810 | 85% |
| Kindful Hospice Contracted [320434] | $810 | 85% |
| Kindful Hospice [20434] | $810 | 85% |
| Medicare (plans) | $810 - $2,207 | 85% |
| Mercy Hospice Okc [20252] | $810 | 85% |
| Pace Of The Ozarks Contracted [320518] | $810 | 85% |
| Tricare | $810 | 85% |
| UnitedHealthcare | $810 - $5,879 | 85% |
| Ambetter / Centene | $826 | 87% |
| American Health Advantage Of Mo Mcr Hmo Contracted [320264] | $826 | 87% |
| Home State Health Plan Contracted [320187] | $826 | 87% |
| Hope Trust Contracted [320488] | $826 - $2,376 | 87% |
| Provider Partners Health Plans Contracted [320450] | $932 | 98% |
| Consociate Consolidated Health Contracted [320490] | $1,134 - $1,823 | 119% |
| Auxiant Contracted [320462] | $1,363 - $2,376 | 143% |
| Ebms Contracted [320493] | $1,363 - $2,376 | 143% |
| Healthlink Contracted [320179] | $1,363 - $2,716 | 143% |
| Imagine 360 Contracted [320494] | $1,363 - $2,376 | 143% |
| Mercy Benefit Admin Contracted [320251] | $1,363 - $2,376 | 143% |
| Reflect Health Contracted [320492] | $1,412 - $2,376 | 149% |
| Preferred Health Plan Contracted [320522] | $1,445 - $2,376 | 152% |
| Health Alliance Contracted [320164] | $2,207 | 232% |
| Aither Health Contracted [320449] | $2,309 | 243% |
| Edison Health Solutions Contracted [320502] | $2,309 | 243% |
| Mercy Benefit Admin [20251] | $2,309 | 243% |
| Yuzu Health Contracted [320521] | $2,309 | 243% |
| First Health Contracted [320128] | $2,546 | 268% |
| Workers Comp [20426] | $2,546 - $2,716 | 268% |
| Multiplan Contracted [320270] | $2,716 | 286% |
| Private Health Care Systems Contracted [320320] | $2,716 | 286% |
| United Medical Resources Contracted [320454] | $5,879 | 619% |
| Cigna | $14,290 | 1504% |