CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Akron Children's Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $348
Cash Discount Price: $422
vs. Medicare Baseline: 0.37x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Akron Children's Hospital is $348. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $422. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.37x the Medicare baseline. Located in 1 Perkins Square, Akron, OH.

Cash / Self-Pay

$422

Average discount available for prompt cash payment at this facility.

Insurance Median

$348

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: $422 (44%)

Insurance Median: $348 (37%)

Cash: $422 (44% of Medicare)

Ins. Median: $348 (37% 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
Aetna	$96 - $1,237	10%
Blue Cross Blue Shield	$98 - $1,237	10%
Buckeye Community Health Plan	$98 - $1,237	10%
Caresource	$98 - $1,213	10%
Molina	$98 - $1,237	10%
Humana	$99 - $1,248	10%
UnitedHealthcare	$99 - $1,272	10%
Amerihealth Caritas Ohio	$101 - $1,272	11%
Autlcare	$170 - $464	18%
Summacare	$176 - $600	19%
Mmo	$276 - $692	29%
Cigna	$279 - $532	29%
Cenpatico	$1,237	130%

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 $422.
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 Children's Hospital 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.