CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Saint Mary's Regional Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,416
  • Cash Discount Price: $1,011
  • vs. Medicare Baseline: 1.49x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Saint Mary's Regional Medical Center is $1,416. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,011. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.49x the Medicare baseline. Located in 235 W 6Th St, Reno, NV.
Cash / Self-Pay
$1,011

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,416

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: $1,011 (106%)
Insurance Median: $1,416 (149%)
Cash: $1,011 (106% of Medicare)
Ins. Median: $1,416 (149% 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.

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 Healthcare Of Nv $209 - $1,012 22%
Access To Healthcare Network $283 30%
Blue Cross Blue Shield $333 - $1,950 35%
Health Plan Of Nevada $333 - $1,012 35%
Medicaid / KanCare $333 35%
Silver Summit $333 - $1,770 35%
Aetna $1,012 - $2,444 107%
Medicare (plans) $1,012 107%
Saint Mary Health Plan $1,012 - $1,163 107%
Sierra $1,012 107%
Tricare $1,012 107%
Triwest $1,012 107%
Alignment $1,032 109%
UnitedHealthcare $1,042 - $2,578 110%
Pam $1,163 122%
Veterans Evaluation Service Ves $1,264 133%
Employer Direct $1,416 149%
Home Town Test $1,416 149%
Naphcare $1,416 149%
Occunet $1,508 - $2,023 159%
Three Rivers $1,508 159%
Asserta Health $1,517 160%
Imperial Insurance Company $1,517 - $1,871 160%
Worker Compensation $1,555 164%
Nevada Health Partners $1,879 198%
6 Degrees $2,023 213%
Nv Preferred $2,151 - $2,296 226%
Custom Ink $2,195 231%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 235 W 6Th St, Reno, NV 89503
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals