CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Methodist Fremont Health

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,480
Cash Discount Price: $979
vs. Medicare Baseline: 1.56x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Methodist Fremont Health is $1,480. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $979. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.56x the Medicare baseline. Located in 450 East 23Rd St, Fremont, NE.

Cash / Self-Pay

$979

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,480

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: $979 (103%)

Insurance Median: $1,480 (156%)

Cash: $979 (103% of Medicare)

Ins. Median: $1,480 (156% 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
Elevate By Medica	$258 - $1,387	27%
Medica	$273 - $1,018	29%
Medicare (plans)	$273 - $1,038	29%
Alliance Nhn	$304 - $1,794	32%
Medica Choice	$304 - $2,712	32%
Aetna	$364 - $2,959	38%
Ne Furniture Mart	$364 - $2,558	38%
UnitedHealthcare	$364 - $2,777	38%
Blue Cross Blue Shield	$395 - $2,620	42%
Multiplan	$546 - $2,774	57%
Ambetter / Centene	$597 - $2,107	63%
Elite Choice	$607 - $2,110	64%
Midlands Choice	$607 - $2,897	64%
Humana	$1,018	107%

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 $979.
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 Methodist Fremont 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.