CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: King's Daughters Medical Center-Brookhaven

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,154
Cash Discount Price: $701
vs. Medicare Baseline: 1.21x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at King's Daughters Medical Center-Brookhaven is $1,154. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $701. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.21x the Medicare baseline. Located in P O Box 948/427 Highway 51 North, Brookhaven, MS.

Cash / Self-Pay

$701

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,154

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: $701 (74%)

Insurance Median: $1,154 (121%)

Cash: $701 (74% of Medicare)

Ins. Median: $1,154 (121% 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.

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
Advanced Health Systems	$507	53%
Blue Cross Blue Shield	$527	55%
Aetna	$854	90%
Cigna	$854 - $2,652	90%
Humana	$854	90%
UnitedHealthcare	$854 - $2,639	90%
Ambetter / Centene	$1,154	121%
Magnolia Health Plan	$1,154	121%
First Choice	$1,282	135%
Vantage Health Plan	$1,965	207%

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 $701.
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 King's Daughters Medical Center-Brookhaven 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.