CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: McKenzie County Healthcare Systems Inc

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,081
Cash Discount Price: $1,120
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at McKenzie County Healthcare Systems Inc is $1,081. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,120. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.14x the Medicare baseline. Located in 709 4Th Ave Ne, Watford City, ND.

Cash / Self-Pay

$1,120

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,081

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: $1,120 (118%)

Insurance Median: $1,081 (114%)

Cash: $1,120 (118% of Medicare)

Ins. Median: $1,081 (114% 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
Humana	$487 - $1,167	51%
Sanford Health Plan	$487 - $2,359	51%
Blue Cross Blue Shield	$496 - $1,634	52%
Medica	$619 - $2,383	65%
First Choice Plus	$892 - $2,140	94%
UnitedHealthcare	$963 - $2,383	101%

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 $1,120.
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 McKenzie County Healthcare Systems Inc 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.