CMS Price Transparency Data
Colonoscopy (diagnostic)
Facility: Mercy Hospital Ardmore, Inc
Billing Code: 45378 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 45378
- Insurance Median: $824
- Cash Discount Price: $1,534
- vs. Medicare Baseline: 0.87x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Mercy Hospital Ardmore, Inc is $824. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,534. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.87x the Medicare baseline. Located in 1011 14Th Ave Nw, Ardmore, OK.
Cash / Self-Pay
$1,534
Average discount available for prompt cash payment at this facility.
Insurance Median
$824
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: $1,534 (161%)
Insurance Median: $824 (87%)
Cash: $1,534 (161% of Medicare)
Ins. Median: $824 (87% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Health Choice Contracted [320166] | $127 - $1,823 | 13% |
| Blue Cross Blue Shield | $170 - $912 | 18% |
| Ambetter / Centene | $380 - $1,254 | 40% |
| Home State Health Plan Contracted [320187] | $380 - $1,254 | 40% |
| Medicaid / KanCare | $380 - $1,254 | 40% |
| Novasys Contracted [320285] | $380 - $1,254 | 40% |
| Medica Contracted [320239] | $486 - $1,268 | 51% |
| UnitedHealthcare | $491 - $929 | 52% |
| Webtpa Contracted [320417] | $533 | 56% |
| Aetna | $557 - $911 | 59% |
| Osma Health Contracted [320292] | $571 | 60% |
| Globalhealth Contracted [320144] | $748 | 79% |
| United Medical Resources Contracted [320454] | $754 - $824 | 79% |
| Aither Health Contracted [320449] | $761 | 80% |
| Auxiant Contracted [320462] | $761 - $824 | 80% |
| Benefit Management Contracted [320052] | $761 - $824 | 80% |
| Ebms Contracted [320493] | $761 | 80% |
| Healthcare Highways Plus Contracted [320175] | $761 | 80% |
| Healthlink Contracted [320179] | $761 - $824 | 80% |
| Imagine 360 Contracted [320494] | $761 | 80% |
| Mercy Benefit Admin Contracted [320251] | $761 - $824 | 80% |
| Quik Trip Contracted [320447] | $761 | 80% |
| Reflect Health Contracted [320492] | $761 | 80% |
| Show-Me Health Administrators Contracted [320483] | $761 | 80% |
| Workers Comp [20426] | $761 - $1,524 | 80% |
| Yuzu Health Contracted [320521] | $761 | 80% |
| Cigna | $771 - $3,261 | 81% |
| Federal Medical Center Contracted [320127] | $824 | 87% |
| Healthscope Contracted [320182] | $824 | 87% |
| Healthsmart Accel Contracted [320183] | $824 | 87% |
| Healthsmart Preferred Care Contracted [320184] | $824 - $2,050 | 87% |
| Point C Contracted [320238] | $824 | 87% |
| Preferred Health Plan Contracted [320522] | $824 | 87% |
| Tri State Healthcare Coalition Contracted [320379] | $824 | 87% |
| First Health Contracted [320128] | $843 | 89% |
| Humana | $875 - $929 | 92% |
| Community Care Contracted [320080] | $888 - $1,393 | 93% |
| Cherokee Nation Health Serv Contracted [320066] | $911 | 96% |
| Cross Timbers Hospice [20098] | $911 | 96% |
| Dept Of Veteran Affairs Contracted [320106] | $911 | 96% |
| Elara Caring Aspire Hospice Contracted [320433] | $911 | 96% |
| Elara Caring Aspire Hospice [20433] | $911 | 96% |
| Halo Hcr Inc Hospice Contracted [320432] | $911 | 96% |
| Halo Hcr Inc Hospice [20432] | $911 | 96% |
| Independent Health [20197] | $911 | 96% |
| Indian Health Service Contracted [320198] | $911 | 96% |
| Kindful Hospice Contracted [320434] | $911 | 96% |
| Kindful Hospice [20434] | $911 | 96% |
| Medical Associates Health [20444] | $911 | 96% |
| Medicare (plans) | $911 - $1,268 | 96% |
| Mercy Hospice Okc [20252] | $911 | 96% |
| Provider Partners Health Plans Contracted [320450] | $911 | 96% |
| Qual Choice Contracted [320325] | $911 | 96% |
| Tribute Health Plan Mcr Contracted [320338] | $911 | 96% |
| Tricare | $911 | 96% |
| Globalhealth Contracted [320145] | $930 | 98% |
| Private Health Care Systems Contracted [320320] | $951 - $1,014 | 100% |
| Preferred Community Choice Contracted [320311] | $964 | 101% |
| Multiplan Contracted [320270] | $1,014 - $1,141 | 107% |
| Kempton Contracted [320214] | $2,050 | 216% |