CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Jefferson Abington Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $275
Cash Discount Price: $1,049
vs. Medicare Baseline: 0.29x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Jefferson Abington Hospital is $275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,049. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.29x the Medicare baseline. Located in 1200 Old York Road, Abington, PA.

Cash / Self-Pay

$1,049

Average discount available for prompt cash payment at this facility.

Insurance Median

$275

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: $1,049 (110%)

Insurance Median: $275 (29%)

Cash: $1,049 (110% of Medicare)

Ins. Median: $275 (29% 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
Medicare (plans)	$55 - $250	6%
Abington Pro Ibc	$97 - $243	10%
Jab Health Partners	$99	10%
Jup Geisinger Commercial	$99 - $445	10%
Jup Health Partners Chip	$120 - $343	13%
Medicaid / KanCare	$120 - $599	13%
Keystone First	$222 - $545	23%
Jup Pa Health_Wellness	$235 - $287	25%
Pa Health_Wellness Chc	$235 - $576	25%
Aetna	$270 - $3,077	28%
Jup Highmark	$345	36%
Ibc	$1,729 - $3,508	182%
Cigna	$2,375 - $2,850	250%
UnitedHealthcare	$2,493	262%
Blue Cross Blue Shield	$2,704	285%

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 $1,049.
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 Jefferson Abington 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.