CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Cherry County Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,303
Cash Discount Price: $2,072
vs. Medicare Baseline: 1.37x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Cherry County Hospital is $1,303. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,072. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.37x the Medicare baseline. Located in 510 North Green St, Valentine, NE.

Cash / Self-Pay

$2,072

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,303

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: $2,072 (218%)

Insurance Median: $1,303 (137%)

Cash: $2,072 (218% of Medicare)

Ins. Median: $1,303 (137% 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
Molina Mcr Adv	$160 - $1,529	17%
Avera Hmo	$212 - $2,716	22%
Ambetter / Centene	$244	26%
Midwest Ntwrk Profee Only - All Plans	$305	32%
Oscar Profee Only - All Plans	$305	32%
Molina Mcaid - All Other Plans	$321 - $1,742	34%
Avera Aca Ppo	$353 - $2,716	37%
Midlands Choice-All Plans	$365 - $2,688	38%
Avera Aso Ppo	$374 - $2,716	39%
Avera Non-Aca Ppo - All Other Plans	$389 - $2,716	41%
UnitedHealthcare	$463 - $2,702	49%
First Choice-All Plans	$1,303 - $2,716	137%
Multiplan-All Plans	$1,303 - $2,716	137%
Phcs-All Plans	$1,303 - $2,716	137%
Tlc Advantage-All Plans	$1,303 - $2,716	137%
Blue Cross Blue Shield	$2,688	283%

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 $2,072.
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 Cherry County Hospital 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.