CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Jacobi Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,079
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Jacobi Medical Center is $1,079. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.14x the Medicare baseline. Located in 1400 Pelham Parkway South, Bronx, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,079

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%)
Insurance Median: $1,079 (114%)
Ins. Median: $1,079 (114% 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
Healthfirst $84 - $2,155 9%
Amidacare $105 - $958 11%
Emblem $105 - $4,821 11%
Aetna $111 - $2,177 12%
Wellcare $113 - $2,013 12%
Fidelis $151 - $2,155 16%
Oscar $157 - $4,454 17%
Metroplus $245 - $2,155 26%
Blue Cross Blue Shield $958 - $2,155 101%
Carelon $958 - $2,181 101%
Senior Whole Health $958 101%
United $958 - $3,275 101%
United Behavioral Health $958 - $1,054 101%
Affinity $977 - $2,155 103%
Carelon (Amida Care) $977 103%
Vnsny $977 - $2,852 103%
Elderplan $1,079 - $2,181 114%
Vaccn $1,079 114%
Centers Plan For Healthy Living $1,122 118%
Centerlight $1,678 177%
Local 1199 $2,334 246%
Oxford $2,337 - $2,648 246%
Magnacare $2,517 265%
Multiplan $2,684 282%
Villagecare Max $2,852 300%
Cigna $4,285 451%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1400 Pelham Parkway South, Bronx, NY 10461
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals