CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: University Hospitals Samaritan Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $2,186
  • Cash Discount Price: $1,952
  • vs. Medicare Baseline: 2.30x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at University Hospitals Samaritan Medical Center is $2,186. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,952. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 2.30x the Medicare baseline. Located in 1025 Center St, Ashland, OH.
Cash / Self-Pay
$1,952

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,186

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: $1,952 (205%)
Insurance Median: $2,186 (230%)
Cash: $1,952 (205% of Medicare)
Ins. Median: $2,186 (230% 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 230% of the Medicare baseline (a markup of 130%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $790 - $2,233 83%
Blue Cross Blue Shield $790 - $2,350 83%
Cigna $790 - $2,399 83%
Devoted Health $790 83%
Humana $790 83%
Molina $790 83%
Primetime Health Plan $790 83%
Summacare $790 - $2,368 83%
The Health Plan $790 - $2,290 83%
UnitedHealthcare $790 - $2,399 83%
Wellcare By Allwell $790 83%
Paramount $814 86%
Perennial Advantage Of Ohio $830 87%
Valor Health Plans $830 87%
Medical Mutual Of Ohio $921 - $2,579 97%
Amish Aid Community Plan $1,197 126%
Amish Church Fund And Workers Aid Plan $1,197 126%
Buckeye Plain Ministries $1,197 126%
Christian Healthcare Ministries $1,301 137%
Immergrun $1,301 137%
Sunrise Plain Communities $1,301 137%
Ambetter / Centene $1,423 150%
Caresource $1,423 150%
University Health Employee Plan (Contigo) $1,786 188%
Medical Mutual Traditional/Health Ohio $1,821 192%
Beech Street $2,082 - $2,342 219%
Ohio Preferred Network $2,082 - $2,342 219%
First Health $2,160 227%
Century Health Network $2,212 233%
Ohio Health Choice $2,212 - $2,342 233%
Private Healthcare System $2,238 236%
Aultcare $2,342 247%
Clarity $2,342 247%
Configurenet $2,342 247%
Fortified Provider Network $2,342 247%
Healthsmart $2,342 247%
Jp Farley $2,342 247%
Multiplan $2,342 247%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1025 Center St, Ashland, OH 44805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals