CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Cayuga Medical Center at Ithaca

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,896
Cash Discount Price: $821
vs. Medicare Baseline: 2.00x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Cayuga Medical Center at Ithaca is $1,896. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $821. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 2.00x the Medicare baseline. Located in 101 Dates Drive, Ithaca, NY.

Cash / Self-Pay

$821

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,896

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: $821 (86%)

Insurance Median: $1,896 (200%)

Cash: $821 (86% of Medicare)

Ins. Median: $1,896 (200% 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
Excellus	$842 - $3,201	89%
Molina	$842 - $1,896	89%
Martins Point	$1,111	117%
Aetna	$1,161 - $3,149	122%
Wellcare	$1,254	132%
Fidelis	$1,896	200%
Cigna	$3,416	360%
UnitedHealthcare	$3,737	393%
Emblem Health	$3,819	402%
Independent Health	$3,942	415%

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 $821.
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 Cayuga Medical Center at Ithaca 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.