CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Bertrand Chaffee Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $315
Cash Discount Price: $254
vs. Medicare Baseline: 0.33x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Bertrand Chaffee Hospital is $315. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $254. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.33x the Medicare baseline. Located in 224 East Main Street, Springville, NY.

Cash / Self-Pay

$254

Average discount available for prompt cash payment at this facility.

Insurance Median

$315

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: $254 (27%)

Insurance Median: $315 (33%)

Cash: $254 (27% of Medicare)

Ins. Median: $315 (33% 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)	$171 - $319	18%
Tricare	$171 - $319	18%
Iha Encompass 65	$172	18%
Private Pay	$245 - $264	26%
Aetna	$288 - $319	30%
American Progressive Ins.	$288 - $310	30%
Cigna	$288 - $319	30%
Commercial / Misc	$288 - $310	30%
Global Excel Mgt	$288 - $310	30%
Guardian Life Ins. Co.	$288 - $310	30%
Mvp Commercial	$288 - $310	30%
No Amer Meritian Health	$288 - $310	30%
No-Fault	$288 - $310	30%
Nova Healthcare	$288 - $310	30%
Blue Cross Blue Shield	$315 - $1,949	33%
Advantra-Mcr Advantage	$319	34%
Centers Plan Hlty Living	$319	34%
Champva	$319	34%
Ctrs Plan For Hlthy Livng	$319	34%
Geisinger Health Plan	$319	34%
Humana	$319	34%
Lifetime Benefits	$319	34%
Mutual Of Omaha	$319	34%
Optimum Healthcare - Mcr	$319	34%
Todays Option - Amer Prog	$319	34%
United Hc Mcr Solutions	$319	34%
UnitedHealthcare	$319	34%
Wellcare	$319	34%
Univera Healthcare	$864	91%
Univera Senior Choice	$864	91%
Senior Blue - Bc	$1,409	148%

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 $254.
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 Bertrand Chaffee 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.