CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Hospital of the Fox Chase Cancer Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,166
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Hospital of the Fox Chase Cancer Center is $1,166. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.23x the Medicare baseline. Located in 333 Cottman Avenue, Philadelphia, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,166

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%)

Insurance Median: $1,166 (123%)

Ins. Median: $1,166 (123% 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
Keystone First	$290 - $1,166	31%
Pennsylvania Health And Wellness	$403 - $2,834	42%
Upmc Health Plan	$614 - $1,175	65%
Blue Cross Blue Shield	$648 - $3,207	68%
UnitedHealthcare	$672	71%
Humana	$955	101%
Health Partners Plans	$975 - $1,670	103%
Clover Health	$1,013	107%
Elder Health	$1,146	121%
Cigna	$1,156	122%
Innovage	$1,156	122%
Aetna	$1,204 - $6,316	127%
Wtc Health Program	$1,274	134%
Oscar Health	$1,433	151%
Prime Health Services	$1,521	160%
Qualcare	$2,602	274%

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 $X.
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 Hospital of the Fox Chase Cancer 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.