CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Rehoboth McKinley Christian Health Care Services

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,032
Cash Discount Price: $375
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Rehoboth McKinley Christian Health Care Services is $1,032. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $375. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.09x the Medicare baseline. Located in 1901 Red Rock Drive, Gallup, NM.

Cash / Self-Pay

$375

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,032

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: $375 (39%)

Insurance Median: $1,032 (109%)

Cash: $375 (39% of Medicare)

Ins. Median: $1,032 (109% 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
Medicare (plans)	$300	32%
Triwest	$300	32%
Usa	$330	35%
Coventry	$751	79%
UnitedHealthcare	$938	99%
Health West	$1,001	105%
Three Rivers	$1,001	105%
Blue Cross Blue Shield	$1,063	112%
Integrated Health	$1,063	112%
Humana	$1,126	119%
Multiplan	$1,126	119%
Cigna	$1,163	122%
Presbyterian	$1,163	122%
Associated Plan Administrators	$1,188	125%

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 $375.
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 Rehoboth McKinley Christian Health Care Services 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.