CMS Price Transparency Data
Colonoscopy (diagnostic)
Facility: Mercy Hospital Oklahoma City, Inc
Billing Code: 45378 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 45378
- Insurance Median: $1,416
- Cash Discount Price: $2,094
- vs. Medicare Baseline: 1.49x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Mercy Hospital Oklahoma City, Inc is $1,416. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,094. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.49x the Medicare baseline. Located in 4300 West Memorial Road, Oklahoma City, OK.
Cash / Self-Pay
$2,094
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,416
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: $2,094 (220%)
Insurance Median: $1,416 (149%)
Cash: $2,094 (220% of Medicare)
Ins. Median: $1,416 (149% 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 | $170 - $912 | 18% |
| Health Choice Contracted [320166] | $236 - $1,641 | 25% |
| Medicaid / KanCare | $250 - $1,171 | 26% |
| Aetna | $340 - $1,706 | 36% |
| Ambetter / Centene | $708 - $1,171 | 75% |
| Home State Health Plan Contracted [320187] | $708 - $1,171 | 75% |
| Novasys Contracted [320285] | $708 - $1,171 | 75% |
| Medica Contracted [320239] | $748 | 79% |
| Tricare | $807 - $851 | 85% |
| Champva [20065] | $851 | 90% |
| Cherokee Nation Health Serv Contracted [320066] | $851 | 90% |
| Cross Timbers Hospice [20098] | $851 | 90% |
| Dept Of Veteran Affairs Contracted [320106] | $851 | 90% |
| Elara Caring Aspire Hospice Contracted [320433] | $851 | 90% |
| Elara Caring Aspire Hospice [20433] | $851 | 90% |
| Halo Hcr Inc Hospice Contracted [320432] | $851 | 90% |
| Halo Hcr Inc Hospice [20432] | $851 | 90% |
| Humana | $851 - $1,628 | 90% |
| Indian Health Service Contracted [320198] | $851 | 90% |
| Kindful Hospice Contracted [320434] | $851 | 90% |
| Kindful Hospice [20434] | $851 | 90% |
| Medicare (plans) | $851 - $911 | 90% |
| Mercy Hospice Okc [20252] | $851 | 90% |
| Mercy Rehab Hospital Contracted [320260] | $851 - $2,360 | 90% |
| Provider Partners Health Plans Contracted [320450] | $851 | 90% |
| Qual Choice Contracted [320325] | $851 | 90% |
| UnitedHealthcare | $851 - $1,534 | 90% |
| Globalhealth Contracted [320145] | $868 | 91% |
| Cigna | $877 - $1,411 | 92% |
| Amg Spec Hosp Edmond [20034] | $911 | 96% |
| Webtpa Contracted [320417] | $991 | 104% |
| Osma Health Contracted [320292] | $1,062 | 112% |
| Community Care Contracted [320080] | $1,301 - $1,652 | 137% |
| Aither Health Contracted [320449] | $1,416 | 149% |
| Auxiant Contracted [320462] | $1,416 - $1,534 | 149% |
| Benefit Management Contracted [320052] | $1,416 - $1,534 | 149% |
| Ebms Contracted [320493] | $1,416 | 149% |
| Healthcare Highways Plus Contracted [320175] | $1,416 | 149% |
| Healthlink Contracted [320179] | $1,416 - $1,534 | 149% |
| Imagine 360 Contracted [320494] | $1,416 | 149% |
| Mercy Benefit Admin Contracted [320251] | $1,416 - $1,534 | 149% |
| Quik Trip Contracted [320447] | $1,416 | 149% |
| Reflect Health Contracted [320492] | $1,416 | 149% |
| Show-Me Health Administrators Contracted [320483] | $1,416 | 149% |
| Workers Comp [20426] | $1,416 - $1,524 | 149% |
| Yuzu Health Contracted [320521] | $1,416 | 149% |
| First Health Contracted [320128] | $1,454 | 153% |
| Federal Medical Center Contracted [320127] | $1,534 | 161% |
| Healthscope Contracted [320182] | $1,534 | 161% |
| Healthsmart Accel Contracted [320183] | $1,534 | 161% |
| Healthsmart Preferred Care Contracted [320184] | $1,534 - $1,914 | 161% |
| Point C Contracted [320238] | $1,534 | 161% |
| Preferred Health Plan Contracted [320522] | $1,534 | 161% |
| Private Health Care Systems Contracted [320320] | $1,534 - $1,652 | 161% |
| Tri State Healthcare Coalition Contracted [320379] | $1,534 | 161% |
| United Medical Resources Contracted [320454] | $1,534 | 161% |
| Globalhealth Contracted [320144] | $1,558 | 164% |
| Multiplan Contracted [320270] | $1,652 - $2,124 | 174% |
| Preferred Community Choice Contracted [320311] | $1,794 | 189% |
| Kempton Contracted [320214] | $1,914 | 201% |
| Centralink Contracted [320480] | $2,360 | 248% |