CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Guthrie Cortland Regional Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,079
Cash Discount Price: $1,969
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Guthrie Cortland Regional Medical Center is $1,079. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,969. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.14x the Medicare baseline. Located in 134 Homer Avenue, Cortland, NY.

Cash / Self-Pay

$1,969

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%)

Cash / Self-Pay: $1,969 (207%)

Insurance Median: $1,079 (114%)

Cash: $1,969 (207% of Medicare)

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.

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
Pa Health And Wellness	$225 - $282	24%
Amerihealth	$235 - $1,190	25%
Geisinger	$237 - $1,079	25%
Aetna	$255 - $1,155	27%
Upmc	$266 - $1,079	28%
Blue Cross Blue Shield	$489 - $3,438	51%
Fidelis	$660 - $1,391	69%
Health Partners	$728 - $1,001	77%
Wellcare	$784 - $5,258	83%
UnitedHealthcare	$795 - $4,364	84%
Cdphp	$851 - $5,258	90%
Freedom Blue	$851	90%
Tricare	$851 - $1,079	90%
Humana	$1,079 - $1,196	114%
Icircle	$1,079 - $2,496	114%
Mvp	$1,079 - $5,258	114%
Emblem	$1,213 - $4,206	128%
Fidelis Essential	$1,788 - $2,496	188%

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 $1,969.
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 Guthrie Cortland Regional Medical Center 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.