CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: NYU Langone Hospitals

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $2,459
Cash Discount Price: $352
vs. Medicare Baseline: 2.59x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at NYU Langone Hospitals is $2,459. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $352. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 2.59x the Medicare baseline. Located in 550 First Avenue, New York, NY.

Cash / Self-Pay

$352

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,459

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: $352 (37%)

Insurance Median: $2,459 (259%)

Cash: $352 (37% of Medicare)

Ins. Median: $2,459 (259% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 259% of the Medicare baseline (a markup of 159%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Healthfirst	$437 - $2,459	46%
Ghi	$1,079 - $12,574	114%
Hip	$1,079 - $8,427	114%
Medicare (plans)	$1,079	114%
Wellcare	$1,079	114%
Amida	$1,093	115%
Fidelis	$1,093 - $2,459	115%
Healthplus	$1,093 - $2,459	115%
Medicaid / KanCare	$1,093	115%
Metroplus	$1,093 - $2,459	115%
UnitedHealthcare	$1,093 - $8,512	115%
Centerlight	$1,100	116%
Somos	$1,148 - $1,475	121%
Multiplan	$1,444	152%
Aetna	$1,851 - $6,733	195%
Hamaspik	$2,158 - $3,702	227%
Oscar	$4,038	425%
1199	$5,050 - $5,941	532%
Oxford	$5,300 - $6,954	558%
Cigna	$5,479	577%
Blue Cross Blue Shield	$5,867 - $7,334	618%
Magnacare	$6,726 - $13,453	708%

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 $352.
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 NYU Langone Hospitals 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.