CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Excela Health Latrobe Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $965
Cash Discount Price: $1,170
vs. Medicare Baseline: 1.02x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Excela Health Latrobe Hospital is $965. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,170. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.02x the Medicare baseline. Located in One Mellon Way, Latrobe, PA.

Cash / Self-Pay

$1,170

Average discount available for prompt cash payment at this facility.

Insurance Median

$965

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: $1,170 (123%)

Insurance Median: $965 (102%)

Cash: $1,170 (123% of Medicare)

Ins. Median: $965 (102% 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
Upmc For Kids Chip	$414	44%
Geisinger	$532 - $951	56%
Health Partners Plans	$532	56%
Highmark Wholecare	$545 - $987	57%
Upmc	$563 - $978	59%
Amerihealth Caritas	$576 - $951	61%
Pa Health And Wellness	$576 - $969	61%
Highmark Advantage Community Blue	$843	89%
Va	$906	95%
Aetna	$933 - $2,083	98%
Health Partners Plan	$933	98%
Martin'S Point	$933	98%
Peak Health	$933 - $2,129	98%
Humana	$942	99%
United	$942	99%
Senior Life	$950	100%
Cigna	$951 - $2,098	100%
Devoted	$951	100%
The Health Plan Of West Virginia	$960 - $2,129	101%
American Health Plan Of Pa	$996	105%
Provider Network Of America	$996 - $1,560	105%
Provider Plan Partners Plan	$996	105%
Upmc Health Plan	$1,051 - $1,819	111%
Highmark Children'S Health Insurance Program	$1,089	115%
Ambetter / Centene	$1,132	119%
Highmark	$1,226 - $1,999	129%
Velocity	$1,359	143%
Community Blue	$1,799	189%
UnitedHealthcare	$2,422	255%

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 $1,170.
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 Excela Health Latrobe Hospital 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.