CMS Price Transparency Data
Colonoscopy (diagnostic)
Facility: Mercy Hospital Logan County
Billing Code: 45378 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 45378
- Insurance Median: $1,415
- Cash Discount Price: $1,533
- vs. Medicare Baseline: 1.49x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Mercy Hospital Logan County is $1,415. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,533. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.49x the Medicare baseline. Located in 200 S Academy Rd, Guthrie, OK.
Cash / Self-Pay
$1,533
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,415
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: $1,533 (161%)
Insurance Median: $1,415 (149%)
Cash: $1,533 (161% of Medicare)
Ins. Median: $1,415 (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
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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] | $236 | 25% |
| Tricare | $585 | 62% |
| Aetna | $602 - $1,385 | 63% |
| Blue Cross Blue Shield | $602 - $1,014 | 63% |
| Cherokee Nation Health Serv Contracted [320066] | $602 | 63% |
| Cross Timbers Hospice [20098] | $602 | 63% |
| Dept Of Veteran Affairs Contracted [320106] | $602 | 63% |
| Elara Caring Aspire Hospice Contracted [320433] | $602 | 63% |
| Elara Caring Aspire Hospice [20433] | $602 | 63% |
| Halo Hcr Inc Hospice Contracted [320432] | $602 | 63% |
| Halo Hcr Inc Hospice [20432] | $602 | 63% |
| Humana | $602 - $1,887 | 63% |
| Independent Health [20197] | $602 | 63% |
| Indian Health Service Contracted [320198] | $602 | 63% |
| Kindful Hospice Contracted [320434] | $602 | 63% |
| Kindful Hospice [20434] | $602 | 63% |
| Medical Associates Health [20444] | $602 | 63% |
| Medicare (plans) | $602 - $1,180 | 63% |
| Mercy Hospice Okc [20252] | $602 | 63% |
| Provider Partners Health Plans Contracted [320450] | $602 | 63% |
| Qual Choice Contracted [320325] | $602 | 63% |
| Tribute Health Plan Mcr Contracted [320338] | $602 | 63% |
| UnitedHealthcare | $602 - $1,651 | 63% |
| Globalhealth Contracted [320145] | $614 | 65% |
| Cigna | $620 - $2,005 | 65% |
| Ambetter / Centene | $708 | 75% |
| Home State Health Plan Contracted [320187] | $708 | 75% |
| Medicaid / KanCare | $708 | 75% |
| Novasys Contracted [320285] | $708 | 75% |
| Webtpa Contracted [320417] | $991 | 104% |
| Medica Contracted [320239] | $1,180 | 124% |
| Aither Health Contracted [320449] | $1,415 - $2,005 | 149% |
| Auxiant Contracted [320462] | $1,415 - $2,005 | 149% |
| Federal Medical Center Contracted [320127] | $1,415 | 149% |
| Healthlink Contracted [320179] | $1,415 - $2,005 | 149% |
| Healthscope Contracted [320182] | $1,415 | 149% |
| Mercy Benefit Admin Contracted [320251] | $1,415 - $2,005 | 149% |
| Point C Contracted [320238] | $1,415 | 149% |
| Preferred Health Plan Contracted [320522] | $1,415 | 149% |
| Quik Trip Contracted [320447] | $1,415 | 149% |
| Show-Me Health Administrators Contracted [320483] | $1,415 | 149% |
| United Medical Resources Contracted [320454] | $1,415 - $1,651 | 149% |
| Community Care Contracted [320080] | $1,651 | 174% |
| Osma Health Contracted [320292] | $1,651 | 174% |
| United Behavioral Health Contracted [320390] | $1,651 | 174% |
| Benefit Management Contracted [320052] | $1,769 - $2,123 | 186% |
| Globalhealth Contracted [320144] | $1,769 | 186% |
| Healthcare Highways Plus Contracted [320175] | $1,769 | 186% |
| Private Health Care Systems Contracted [320320] | $1,769 - $1,887 | 186% |
| First Health Contracted [320128] | $1,845 | 194% |
| Multiplan Contracted [320270] | $1,887 - $2,123 | 199% |
| Ebms Contracted [320493] | $2,005 | 211% |
| Imagine 360 Contracted [320494] | $2,005 | 211% |
| Preferred Community Choice Contracted [320311] | $2,005 | 211% |
| Reflect Health Contracted [320492] | $2,005 | 211% |
| Yuzu Health Contracted [320521] | $2,005 | 211% |