CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Akron General Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $599
Cash Discount Price: $660
vs. Medicare Baseline: 0.63x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Akron General Medical Center is $599. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $660. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.63x the Medicare baseline. Located in 1 Akron General Avenue, Akron, OH.

Cash / Self-Pay

$660

Average discount available for prompt cash payment at this facility.

Insurance Median

$599

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: $660 (69%)

Insurance Median: $599 (63%)

Cash: $660 (69% of Medicare)

Ins. Median: $599 (63% 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
UnitedHealthcare	$89 - $842	9%
Buckeye	$93 - $738	10%
Caresource	$98 - $738	10%
United	$98 - $4,831	10%
Amerihealth	$103 - $812	11%
Molina	$103 - $775	11%
Summacare	$112 - $842	12%
Oscar	$168 - $374	18%
Aetna	$173 - $1,402	18%
Blue Cross Blue Shield	$173 - $2,249	18%
Humana	$173 - $842	18%
The Health Plan	$173 - $872	18%
Valor	$173 - $842	18%
Communicare	$181	19%
Pphp	$186 - $927	20%
Zing Health	$190 - $927	20%
Aultcare	$226	24%
Ohcp	$245 - $545	26%
Cigna	$247 - $868	26%
Omas	$315 - $701	33%
Phphi	$378 - $841	40%
Mmo	$384 - $2,475	40%
Gms	$441 - $981	46%
Consociate Health	$472 - $1,052	50%
Multiplan	$567 - $1,262	60%
United Bh	$782	82%
Upmc	$790	83%
Perennial Health	$910	96%

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 $660.
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 Akron General 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.