CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Long Island Community Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,851
  • Cash Discount Price: $241
  • vs. Medicare Baseline: 1.95x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Long Island Community Hospital is $1,851. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $241. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.95x the Medicare baseline. Located in 101 Hospital Road, Patchogue, NY.
Cash / Self-Pay
$241

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,851

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: $241 (25%)
Insurance Median: $1,851 (195%)
Cash: $241 (25% of Medicare)
Ins. Median: $1,851 (195% 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
Local 1199 $435 46%
Magellan $566 60%
Multiplan $566 60%
Oscar Health Exchange $592 62%
Coventry $644 68%
Longevity Health $697 73%
Galaxy $784 83%
Aarp $871 92%
Aetna $871 - $6,906 92%
Beacon Health Options $871 92%
Blue Cross Blue Shield $871 - $3,309 92%
Centerlight $871 92%
Cigna $871 - $5,096 92%
Emblem Ghi $871 92%
Fidelis $871 92%
Humana $871 92%
Integra $871 92%
Medicare (plans) $871 92%
UnitedHealthcare $871 - $5,177 92%
Agewell $901 95%
Elderplan Inc. $958 101%
Wellcare $958 101%
Emblem $1,851 - $3,174 195%
Empire Mediblue $1,851 - $3,309 195%
Magnacare $1,851 - $9,174 195%
Nexus Nyu $1,851 - $4,542 195%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 101 Hospital Road, Patchogue, NY 11772
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals