CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Milton S Hershey Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,067
Cash Discount Price: $1,963
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Milton S Hershey Medical Center is $1,067. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,963. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.12x the Medicare baseline. Located in 500 University Drive, Hershey, PA.

Cash / Self-Pay

$1,963

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,067

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: $1,963 (207%)

Insurance Median: $1,067 (112%)

Cash: $1,963 (207% of Medicare)

Ins. Median: $1,067 (112% 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
[Amerihealth Caritas]	$838 - $986	88%
[Highmark Wholecare]	$838 - $986	88%
[Geisinger]	$888 - $4,416	93%
[Health Partners Plans]	$917 - $1,006	97%
[Pa Health & Wellness]	$922 - $1,016	97%
[Highmark]	$976 - $5,304	103%
Aetna	$996 - $4,014	105%
Humana	$996	105%
[Healthspring]	$996	105%
UnitedHealthcare	$1,006 - $4,273	106%
[Upmc]	$1,006 - $4,378	106%
[Cbc]	$1,067 - $3,925	112%
[Point Comfort Underwriters]	$1,233	130%
[Highmark Aca]	$3,713	391%
Cigna	$3,788	399%
[Highmark Choice Blue]	$4,243	447%
[Preferred Healthcare Systems]	$4,444	468%
[First Health]	$4,741	499%
[Multiplan]	$4,741	499%

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 $1,963.
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 Milton S Hershey 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.