CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Great Plains Health

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $5,303
Cash Discount Price: $3,650
vs. Medicare Baseline: 5.58x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Great Plains Health is $5,303. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,650. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 5.58x the Medicare baseline. Located in 601 West Leota St, North Platte, NE.

Cash / Self-Pay

$3,650

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,303

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: $3,650 (384%)

Insurance Median: $5,303 (558%)

Cash: $3,650 (384% of Medicare)

Ins. Median: $5,303 (558% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 558% of the Medicare baseline (a markup of 458%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Nebraska Total Care	$165 - $958	17%
Molina	$180 - $1,045	19%
Blue Cross Blue Shield	$687 - $5,384	72%
Ambetter / Centene	$749 - $4,354	79%
Midlands Choice	$1,076 - $5,658	113%
Midwest Network Alliance	$5,121 - $5,303	539%
Medica	$5,597	589%
Oscar Health	$5,658	596%
Coventry	$5,719 - $5,780	602%
Geha	$5,719	602%
Mutual Of Omaha	$5,780	608%
UnitedHealthcare	$5,780	608%

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 $3,650.
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 Great Plains Health 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.