CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Sunrise Hospital and Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $261
Cash Discount Price: $1,057
vs. Medicare Baseline: 0.27x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Sunrise Hospital and Medical Center is $261. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,057. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.27x the Medicare baseline. Located in 3186 S Maryland Pkwy, Las Vegas, NV.

Cash / Self-Pay

$1,057

Average discount available for prompt cash payment at this facility.

Insurance Median

$261

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: $1,057 (111%)

Insurance Median: $261 (27%)

Cash: $1,057 (111% of Medicare)

Ins. Median: $261 (27% 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
Culinary Health Fund	$59 - $488	6%
Healthcare Partners Of Nv	$86 - $438	9%
Aetna	$88 - $2,138	9%
Alignment Health Plan	$88 - $326	9%
Blue Cross Blue Shield	$88 - $3,720	9%
Caremore	$92 - $342	10%
Hometown Health Providers	$101 - $2,339	11%
Silver Summit	$110 - $407	12%
Sierra	$114 - $1,884	12%
Multiplan	$117 - $3,500	12%
Humana	$130 - $2,704	14%
Amerigroup	$134 - $249	14%
Health Plan Nevada	$134 - $261	14%
Molina	$141 - $274	15%
Select Health	$176 - $5,307	19%
United	$179 - $2,295	19%
Community Care Health	$205 - $333	22%
Molina Healthcare	$205 - $346	22%
Sierra Hpn	$205 - $333	22%
Cigna	$231 - $6,461	24%
Caresource	$346	36%
Legacy Provider Network	$1,267	133%
Corvel	$1,338 - $1,520	141%
Comp-Med Workers Comp	$1,366	144%
Olympus Medsave Usa	$1,408 - $1,600	148%
Ambetter / Centene	$2,550 - $2,626	268%
Health Services Coalition	$4,260	448%

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 $1,057.
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 Sunrise Hospital and Medical Center 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.