CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Hillsboro Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,127
Cash Discount Price: $2,685
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Hillsboro Medical Center is $1,127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,685. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.19x the Medicare baseline. Located in 335 Se 8Th Avenue, Hillsboro, OR.

Cash / Self-Pay

$2,685

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,127

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: $2,685 (283%)

Insurance Median: $1,127 (119%)

Cash: $2,685 (283% of Medicare)

Ins. Median: $1,127 (119% 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
Care Oregon	$806 - $1,220	85%
Intercommunity Health Network	$806	85%
Medicare (plans)	$806 - $1,220	85%
Kaiser Foundation Hospitals	$827 - $3,029	87%
Pacific Source	$827 - $2,643	87%
Community Health Plan Of Washington	$1,034 - $4,130	109%
Providence Health Plan	$1,034 - $1,858	109%
Samaritan Health Plan	$1,034	109%
Trillium	$1,034	109%
Humana	$1,065 - $1,096	112%
UnitedHealthcare	$1,096 - $3,481	115%
Aetna	$1,116 - $4,130	117%
Moda	$1,137 - $3,721	120%
Health Net Health Plan Of Oregon, Inc.	$1,189 - $2,726	125%
Tuality Health	$1,861	196%
Blue Cross Blue Shield	$2,691	283%
Cigna	$2,850	300%
First Choice	$3,304	348%
Coventry First Health	$3,510	369%
Molina Exchange	$4,130	435%

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 $2,685.
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 Hillsboro Medical Center 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.