CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Summa Health System

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,372
Cash Discount Price: $2,359
vs. Medicare Baseline: 1.44x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Summa Health System is $1,372. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,359. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.44x the Medicare baseline. Located in 525 East Market Street, Akron, OH.

Cash / Self-Pay

$2,359

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,372

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: $2,359 (248%)

Insurance Median: $1,372 (144%)

Cash: $2,359 (248% of Medicare)

Ins. Median: $1,372 (144% 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
Medical Mutual	$807 - $3,908	85%
Medical Mutual - Asc	$863 - $1,015	91%
Aetna	$880 - $5,050	93%
Cigna	$906 - $3,043	95%
Caresource	$924	97%
UnitedHealthcare	$990 - $3,321	104%
Buckeye Health Plan	$1,100 - $1,628	116%
Ohio Health Choice - Asc	$1,100	116%
Summacare	$1,245 - $2,059	131%
Blue Cross Blue Shield	$1,382 - $3,102	145%
The Health Plan	$1,914	201%

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 $2,359.
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 Summa Health System 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.