CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Arthur G James Cancer Hospital and Research Institute

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,517
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.60x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Arthur G James Cancer Hospital and Research Institute is $1,517. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.60x the Medicare baseline. Located in 460 W 10Th Ave, Columbus, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,517

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%)
Insurance Median: $1,517 (160%)
Ins. Median: $1,517 (160% 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
Healthspan $573 - $5,413 60%
Medigold $573 60%
Upper Ohio Valley $573 - $5,413 60%
Medicare (plans) $579 - $5,467 61%
Humana $584 - $5,521 61%
Medicaid / KanCare $662 - $909 70%
Aetna $695 - $5,388 73%
United $728 - $2,381 77%
Caresource $863 - $1,291 91%
Mmo $863 - $2,209 91%
Molina $863 - $5,388 91%
Odrc $909 - $1,064 96%
Blue Cross Blue Shield $961 - $2,480 101%
Buckeye Community $965 - $1,282 102%
Amerihealth $973 - $1,410 102%
Osu Health Plan $1,195 - $1,732 126%
Lifetrac $1,700 - $1,779 179%
Ohio Ppo $1,717 181%
Ohiohealth $1,884 - $1,910 198%
Cigna $1,896 - $1,963 200%
Frontpath $2,093 220%
Healthsmart $2,354 248%
Multiplan $2,433 256%
Ohio Dept Of Health $4,289 451%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 460 W 10Th Ave, Columbus, OH 43210
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL