CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Central Montana Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,630
Cash Discount Price: $1,485
vs. Medicare Baseline: 1.72x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Central Montana Medical Center is $1,630. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,485. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.72x the Medicare baseline. Located in 408 Wendell Ave, Lewistown, MT.

Cash / Self-Pay

$1,485

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,630

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: $1,485 (156%)

Insurance Median: $1,630 (172%)

Cash: $1,485 (156% of Medicare)

Ins. Median: $1,630 (172% 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	$177 - $3,076	19%
Humana	$177 - $1,661	19%
Triwest - All Plans	$177 - $1,630	19%
Veterans Affairs - All Plans	$177 - $1,630	19%
Montana Health Co-Op - All Plans	$291 - $2,983	31%
Allegiance Comm - All Other Plans	$303 - $2,952	32%
Allegiance Rbphp	$303 - $5,567	32%
Ebms - All Plans	$321 - $2,922	34%
Health Infonet - All Plans	$321 - $2,952	34%
Coventry/First Health - All Plans	$2,860	301%
UnitedHealthcare	$2,860	301%
Interwest Ppo	$3,014	317%
Pacific Source Hp - All Plans	$3,014	317%
Interwest Trad - All Other Plans	$3,076	324%

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 $1,485.
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 Central Montana Medical Center 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.