CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Barrett Hospital & Healthcare

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $321
Cash Discount Price: $819
vs. Medicare Baseline: 0.34x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Barrett Hospital & Healthcare is $321. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $819. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.34x the Medicare baseline. Located in 600 Mt Hwy 91 S, Dillon, MT.

Cash / Self-Pay

$819

Average discount available for prompt cash payment at this facility.

Insurance Median

$321

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: $819 (86%)

Insurance Median: $321 (34%)

Cash: $819 (86% of Medicare)

Ins. Median: $321 (34% 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
Interwest Health Ppo - All Other Plans	$161	17%
Humana	$165	17%
UnitedHealthcare	$165 - $521	17%
Allegiance - All Plans	$287	30%
Montana Health Coop - All Plans	$299	31%
First Choice - All Plans	$312	33%
Ebms - All Plans	$318	33%
Pacific Source - All Plans	$321	34%
Interwest Health Traditional	$353	37%
Blue Cross Blue Shield	$536	56%
Interwest Health Ppo Direct	$690	73%

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 $819.
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 Barrett Hospital & Healthcare 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.