CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Fairview Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,474
  • Cash Discount Price: $2,445
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Fairview Hospital is $1,474. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,445. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.55x the Medicare baseline. Located in 18101 Lorain Avenue, Cleveland, OH.
Cash / Self-Pay
$2,445

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,474

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: $2,445 (257%)
Insurance Median: $1,474 (155%)
Cash: $2,445 (257% of Medicare)
Ins. Median: $1,474 (155% 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.

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
Blue Cross Blue Shield $699 - $2,413 74%
UnitedHealthcare $723 - $2,332 76%
Paramount $784 83%
Humana $793 - $3,198 83%
Buckeye $800 84%
Molina $800 84%
United Bh $807 85%
Caresource $815 86%
United $815 - $4,831 86%
Amerihealth $838 88%
Aetna $845 - $4,001 89%
Devoted Health $845 89%
Mmo $845 - $2,475 89%
Summacare $845 - $1,426 89%
The Health Plan $845 - $2,257 89%
Upmc $845 - $2,257 89%
Valor $845 89%
Cigna $871 - $3,010 92%
Communicare $887 93%
Perennial Health $913 96%
Pphp $930 98%
Zing Health $930 98%
Oscar $1,133 - $1,446 119%
Cc Ehp $1,501 - $1,524 158%
Aultcare $1,618 170%
Amish Community Aid Plan $1,693 - $1,881 178%
Ohcp $1,828 192%
Omas $1,881 198%
Ohio Healthy $2,031 214%
Healthsmart $2,069 218%
Php $2,257 238%
Phphi $2,257 238%
Gms $2,633 277%
Medical Benefit Corp $2,633 277%
Quality Care Partners $2,633 277%
Consociate Health $2,822 297%
Managed Care Services $3,010 317%
Frontpath $3,386 356%
Multiplan $3,386 356%
Tertiary Care Network $3,386 356%
Three Rivers $3,386 356%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 18101 Lorain Avenue, Cleveland, OH 44111
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals