CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Tippah County Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $294
Cash Discount Price: $3,450
vs. Medicare Baseline: 0.31x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Tippah County Hospital is $294. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,450. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.31x the Medicare baseline. Located in 1005 City Ave North, Ripley, MS.

Cash / Self-Pay

$3,450

Average discount available for prompt cash payment at this facility.

Insurance Median

$294

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: $3,450 (363%)

Insurance Median: $294 (31%)

Cash: $3,450 (363% of Medicare)

Ins. Median: $294 (31% 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
Medicare (plans)	$152 - $1,944	16%
Aetna	$186 - $1,944	20%
Humana	$188 - $1,964	20%
Molina Healthcare Of Mississippi	$190 - $1,984	20%
Magnolia Health Plan Mcd Rep	$269 - $677	28%
Molina Healthcare Of Ms Mcd Rep	$269 - $677	28%
UnitedHealthcare	$412 - $5,280	43%

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 $3,450.
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 Tippah County 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.