CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Ohio Valley Surgical Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $869
  • Cash Discount Price: $4,367
  • vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Ohio Valley Surgical Hospital is $869. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,367. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.91x the Medicare baseline. Located in 100 West Main Street, Springfield, OH.
Cash / Self-Pay
$4,367

Average discount available for prompt cash payment at this facility.

Insurance Median
$869

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: $4,367 (460%)
Insurance Median: $869 (91%)
Cash: $4,367 (460% of Medicare)
Ins. Median: $869 (91% 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
Aetna $395 - $869 42%
Geha $395 42%
Genworth $395 42%
Mail Handlers $395 42%
Meritain $395 42%
Meritain Heatlh $395 42%
Mhbp $395 42%
Ngs Coresource $395 42%
Nippon Life $395 42%
Pacific Source $395 42%
Personify Health $395 42%
Aarp $869 91%
Aarp Supplemental $869 91%
American Continental Insurance $869 91%
American Continental Life $869 91%
American Republic $869 91%
American Retirement $869 91%
Aultcare Primetime Health Plan $869 91%
Bankers Fidelity $869 91%
Bankers Life And Casualty $869 91%
Blue Cross Blue Shield $869 - $7,170 91%
Central States $869 91%
Champus $869 91%
Cigna $869 - $1,366 91%
Communicare Advantage $869 91%
Everest $869 91%
Gateway Health Plan $869 91%
Humana $869 91%
Medicare (plans) $869 - $4,367 91%
Medigold $869 91%
Mmoh $869 - $4,586 91%
Molina $869 91%
Molina Dual Mcr $869 91%
Molina Marketplace $869 91%
Molina Dual Mcr $869 91%
Molina Mcr $869 91%
Molina Mcr Mcd $869 91%
Molina Mcr+Mcd $869 91%
Patient No Pay $869 91%
Prosperity Supplement $869 91%
Self Pay Imaging $869 91%
UnitedHealthcare $869 - $2,869 91%
Wellcare By Allwell $869 91%
Wraparound Pl Supp $869 91%
The Health Plan $912 96%
Devoted Health $935 98%
Employer Direct $999 105%
Caresource $1,303 137%
Caresourse $1,303 137%
Medicaid / KanCare $1,303 137%
Healthgram $1,366 144%
Nalc $1,366 144%
Samba $1,366 144%
Sbma $1,366 144%
Unified Group $1,366 144%
Mmoh (Supermed) $3,385 356%
Mmo Cin. Hmo $4,586 483%
Luminare Health $6,551 690%
Medben $6,551 690%
Ohio Health $6,551 690%
Preferred Health $6,551 690%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 West Main Street, Springfield, OH 45502
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals