CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Essentia Health

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,512
  • Cash Discount Price: $2,120
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Essentia Health is $1,512. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,120. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.59x the Medicare baseline. Located in 3000 32Nd Ave South, Fargo, ND.
Cash / Self-Pay
$2,120

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,512

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: $2,120 (223%)
Insurance Median: $1,512 (159%)
Cash: $2,120 (223% of Medicare)
Ins. Median: $1,512 (159% 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
Medica Access $758 80%
Primewest $881 93%
Advocare/Security Health $912 96%
Blue Cross Blue Shield $912 - $2,088 96%
Freedom Blue Ppo $912 96%
Healthpartners Care Msho / Mcr Adv $912 96%
Imcare Msho Pcc Prime $912 96%
Imcare Msho Ref Req $912 96%
Itasca Med Care $912 96%
Medica Advantage Solutions $912 96%
Medica Msho/Dual Solutions $912 96%
Medica Prime Solution Group $912 96%
Medicare (plans) $912 96%
Nd Va Administration $912 96%
Platinum Blue/Vantage Blue $912 96%
Primewest Msho $912 96%
Secure Blue Msho $912 96%
Ubh Cost Plan $912 96%
Ubh Msho $912 96%
Ucare Msho $912 96%
UnitedHealthcare $912 - $2,253 96%
Healthpartners Care Pmap $1,100 116%
Sanford Health Plan $1,212 - $1,614 128%
Medica $1,566 - $1,741 165%
Medica Uplan $1,566 165%
Medica Choice $1,792 189%
Ucare $1,860 196%
Cigna $1,894 199%
Healthpartners $1,894 199%
Healthpartners Pcc Prime $1,894 199%
Wea $2,035 - $2,177 214%
America'S Ppo $2,191 231%
Wps $2,346 - $2,375 247%
Aetna $2,403 253%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3000 32Nd Ave South, Fargo, ND 58104
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals