CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Mercy Hospital Marietta

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $651
Cash Discount Price: $1,085
vs. Medicare Baseline: 0.69x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Mercy Hospital Marietta is $651. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,085. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.69x the Medicare baseline. Located in 300 Wanda Street, Marietta, OK.

Cash / Self-Pay

$1,085

Average discount available for prompt cash payment at this facility.

Insurance Median

$651

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: $1,085 (114%)

Insurance Median: $651 (69%)

Cash: $1,085 (114% of Medicare)

Ins. Median: $651 (69% 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	$351 - $756	37%
Blue Cross Blue Shield	$351 - $499	37%
Cross Timbers Hospice [20098]	$351	37%
Elara Caring Aspire Hospice Contracted [320433]	$351	37%
Elara Caring Aspire Hospice [20433]	$351	37%
Halo Hcr Inc Hospice Contracted [320432]	$351	37%
Halo Hcr Inc Hospice [20432]	$351	37%
Humana	$351	37%
Independent Health [20197]	$351	37%
Indian Health Service Contracted [320198]	$351	37%
Kindful Hospice Contracted [320434]	$351	37%
Kindful Hospice [20434]	$351	37%
Medical Associates Health [20444]	$351	37%
Medicare (plans)	$351 - $369	37%
Mercy Hospice Okc [20252]	$351	37%
UnitedHealthcare	$369 - $760	39%
Tricare	$371	39%
Cigna	$384 - $814	40%
Webtpa Contracted [320417]	$456	48%
Aither Health Contracted [320449]	$651 - $922	69%
Mercy Benefit Admin Contracted [320251]	$651 - $976	69%
Quik Trip Contracted [320447]	$651	69%
Show-Me Health Administrators Contracted [320483]	$651	69%
Osma Health Contracted [320292]	$760	80%
United Medical Resources Contracted [320454]	$760 - $976	80%
First Health Contracted [320128]	$767	81%
Benefit Management Contracted [320052]	$814 - $976	86%
Healthcare Highways Plus Contracted [320175]	$814	86%
Auxiant Contracted [320462]	$922 - $976	97%
Ebms Contracted [320493]	$922	97%
Healthlink Contracted [320179]	$922 - $976	97%
Preferred Community Choice Contracted [320311]	$922	97%
Federal Medical Center Contracted [320127]	$976	103%
Healthscope Contracted [320182]	$976	103%
Point C Contracted [320238]	$976	103%
Preferred Health Plan Contracted [320522]	$976	103%
Tri State Healthcare Coalition Contracted [320379]	$976	103%

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 $1,085.
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 Mercy Hospital Marietta 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.