CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Incline Village Community Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $902
Cash Discount Price: $1,541
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Incline Village Community Hospital is $902. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,541. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.95x the Medicare baseline. Located in 880 Alder Street, Incline Village, NV.

Cash / Self-Pay

$1,541

Average discount available for prompt cash payment at this facility.

Insurance Median

$902

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: $1,541 (162%)

Insurance Median: $902 (95%)

Cash: $1,541 (162% of Medicare)

Ins. Median: $902 (95% 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)	$162 - $832	17%
Healthnet - All Plans	$219 - $2,026	23%
Blue Cross Blue Shield	$227 - $1,920	24%
Ca Hlth And Wellness - All Plans	$232 - $2,176	24%
UnitedHealthcare	$311 - $1,920	33%
Aetna	$835 - $1,877	88%
Prominence Healthfirst - All Plans	$835 - $1,877	88%
Admar Multiplan - All Plans	$854 - $1,920	90%
First Health - All Plans	$854 - $1,920	90%
Great West/One Health - All Plans	$854 - $1,920	90%
Hometown Hp - All Plans	$854 - $1,920	90%
Humana	$854 - $1,920	90%
Interplan - All Plans	$854 - $1,920	90%
Multiplan - All Plans	$854 - $1,920	90%
Phcs - All Plans	$854 - $1,920	90%
Cigna	$873 - $1,962	92%
Beech Street/Capp Care - All Plans	$902 - $2,026	95%
Uhn - All Plans	$902 - $2,026	95%
Sierra Health - All Plans	$921 - $2,069	97%

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 $1,541.
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 Incline Village Community 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.