CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Carolina East Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $959
  • Cash Discount Price: $1,135
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Carolina East Medical Center is $959. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,135. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.01x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.
Cash / Self-Pay
$1,135

Average discount available for prompt cash payment at this facility.

Insurance Median
$959

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: $1,135 (119%)
Insurance Median: $959 (101%)
Cash: $1,135 (119% of Medicare)
Ins. Median: $959 (101% 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.

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
Humana $157 - $889 17%
Inclusive Health (Nchirp)-All Plans $157 - $889 17%
Tricare $157 - $2,700 17%
Pamlico Co Jail-All Plans $288 - $718 30%
UnitedHealthcare $379 - $1,920 40%
Craven Co. Jail Systems - All Plans $584 - $910 61%
Medcost Ppo Employees And Retirees $712 - $1,773 75%
Medcost Ppo Ultra (Employees) $712 - $1,689 75%
Blue Cross Blue Shield $757 - $1,852 80%
Medcost Ppo City Employees $790 - $1,967 83%
Medcost Ppo County Employee $821 - $2,045 86%
Benefit Mgmt, Svcs-All Plans $921 - $2,295 97%
Medcost Benefit Svc-All Other Plans $958 - $2,386 101%
Aetna $960 - $2,392 101%
Acs Consult Svc Inc-All Plans $979 - $2,439 103%
Medcost Ppo Standard $979 - $2,439 103%
Cigna $986 - $2,457 104%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 Neuse Blvd, New Bern, NC 28560
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals