CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Ochsner Stennis Memorial Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,130
Cash Discount Price: $1,287
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Ochsner Stennis Memorial Hospital is $1,130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,287. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.19x the Medicare baseline. Located in 14365 Highway 16 West, De Kalb, MS.

Cash / Self-Pay

$1,287

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,130

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: $1,287 (135%)

Insurance Median: $1,130 (119%)

Cash: $1,287 (135% of Medicare)

Ins. Median: $1,130 (119% 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
Blue Cross Blue Shield	$507	53%
Medicaid / KanCare	$677 - $711	71%
Humana	$757 - $1,119	80%
UnitedHealthcare	$951 - $1,182	100%
Prime Health Services Ppo -Workers Comp	$1,005	106%
Cor Vel	$1,026	108%
Cigna	$1,065 - $1,119	112%
Medicare (plans)	$1,119 - $1,287	118%
Ambetter / Centene	$1,130	119%
Magnolia Health Plan – Wellcare By All Well Of Mississippi	$1,130	119%
Shared Health Mississippi	$1,175	124%
Aetna	$1,212	128%
Primewell Health Services Commercial Exchange Plan	$1,249	131%
Primewell Health Services – Commercial	$1,249	131%
Select Administrative Services Network	$1,305	137%
Claritev D/B/A Multiplan/Phcs/American Life Care	$1,398	147%
Zelis	$1,398	147%
Prime Health Services Ppo	$1,492	157%

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 $1,287.
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 Ochsner Stennis Memorial Hospital 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.