CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Cleveland Clinic

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $929
  • Cash Discount Price: $2,445
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Cleveland Clinic is $929. 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 0.98x the Medicare baseline. Located in 9500 Euclid Avenue, Cleveland, OH.
Cash / Self-Pay
$2,445

Average discount available for prompt cash payment at this facility.

Insurance Median
$929

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: $929 (98%)
Cash: $2,445 (257% of Medicare)
Ins. Median: $929 (98% 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
UnitedHealthcare $89 - $2,521 9%
Paramount $96 - $957 10%
Buckeye $98 - $976 10%
Caresource $98 - $929 10%
United $100 - $6,112 11%
Amerihealth $103 11%
Molina $103 - $976 11%
Summacare $112 - $1,794 12%
Aetna $173 - $4,016 18%
Blue Cross Blue Shield $173 - $3,195 18%
Devoted Health $173 - $845 18%
Humana $173 - $3,198 18%
The Health Plan $173 - $2,257 18%
Upmc $173 - $2,257 18%
Valor $173 - $845 18%
Cigna $178 - $3,010 19%
Communicare $181 - $887 19%
Perennial Health $186 - $913 20%
Pphp $186 - $930 20%
Zing Health $190 - $930 20%
Cc Ehp $328 - $2,347 35%
Oscar $374 - $1,446 39%
Mmo $533 - $4,658 56%
Ohcp $545 - $1,828 57%
Ohio Healthy $561 - $2,633 59%
Aultcare $603 - $1,843 63%
Amish Community Aid Plan $631 - $1,881 66%
Omas $701 - $1,881 74%
Healthsmart $771 - $2,069 81%
Phphi $841 - $2,257 89%
Clarity Health $911 - $2,445 96%
Gms $981 - $2,633 103%
Quality Care Partners $981 - $2,633 103%
United Bh $1,022 108%
Consociate Health $1,052 - $2,822 111%
Multiplan $1,262 - $3,386 133%
Three Rivers $1,262 - $3,386 133%
Usa Managed Care $1,262 133%
Php $2,257 238%
Medical Benefit Corp $2,633 277%
Parkview Health Plan $2,633 277%
Community Health Alliance $3,010 317%
Managed Care Services $3,010 317%
Frontpath $3,386 356%
Tertiary Care Network $3,386 356%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9500 Euclid Avenue, Cleveland, OH 44195
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals