CMS Price Transparency Data
Colonoscopy (diagnostic)
Facility: St Mary Medical Center
Billing Code: 45378 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 45378
- Insurance Median: $90
- Cash Discount Price: $1,515
- vs. Medicare Baseline: 0.09x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at St Mary Medical Center is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,515. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.09x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.
Cash / Self-Pay
$1,515
Average discount available for prompt cash payment at this facility.
Insurance Median
$90
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: $1,515 (159%)
Insurance Median: $90 (9%)
Cash: $1,515 (159% of Medicare)
Ins. Median: $90 (9% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $58 - $2,581 | 6% |
| Community Health Choice | $68 - $90 | 7% |
| Aetna | $84 - $1,061 | 9% |
| Align Senior Care | $84 - $1,023 | 9% |
| Ally Align Care Adv | $84 | 9% |
| American Health Advantage Of Idaho | $84 | 9% |
| American Health Plan | $84 | 9% |
| Aurora Special Needs | $84 | 9% |
| Blue Care Network Advantage | $84 | 9% |
| Blue Cross Blue Shield | $84 - $4,967 | 9% |
| Blue Shield - De (Highmark) Medciare Advantage | $84 | 9% |
| Care Dimensions | $84 | 9% |
| Care Improvement Plus | $84 | 9% |
| Care Resources Pace | $84 | 9% |
| Careplus Health Plans | $84 | 9% |
| Cca - Zing Health | $84 | 9% |
| Cca Senior Care Options | $84 | 9% |
| Central Valley Medical Services Corp Pace | $84 | 9% |
| Champion Health Plan Mcr Advantage | $84 | 9% |
| Cigna | $84 - $4,432 | 9% |
| Clear Spring Health | $84 | 9% |
| Clover Health | $84 | 9% |
| Commonwealth Care Alliance | $84 | 9% |
| Community Pace At Home | $84 | 9% |
| Eddy Senior Care-Pace | $84 | 9% |
| Eddy Seniorcare Pace | $84 | 9% |
| Elementcare | $84 | 9% |
| Everence | $84 | 9% |
| Gateway Health Plan | $84 | 9% |
| Genesys Pace Of Genesee County | $84 | 9% |
| Georgia Health Advantage | $84 | 9% |
| Gold Advantage | $84 | 9% |
| Gpa Croell Redi Mix | $84 | 9% |
| Highmark Health Options Dual Plan | $84 | 9% |
| Hope Select Pace | $84 | 9% |
| Horizon Nj Total Care | $84 | 9% |
| Hudson Headwaters Pace | $84 | 9% |
| Humana | $84 - $428 | 9% |
| Huron Valley Pace | $84 | 9% |
| Innovative Integrated Health Community Plans | $84 | 9% |
| Iowa Health Advantage | $84 | 9% |
| Johns Hopkins Advantage Md | $84 | 9% |
| Lasso Healthcare Msa | $84 | 9% |
| Life St Marys Pace | $84 | 9% |
| Lifecircles Pace | $84 | 9% |
| Longevity Health Plan | $84 | 9% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $84 | 9% |
| Martins Point Generations Advantage | $84 | 9% |
| Mass General Brigham Mcr Adv | $84 | 9% |
| Medicare (plans) | $84 - $1,805 | 9% |
| Medipak Advantage | $84 | 9% |
| Mercy Life | $84 | 9% |
| Mercyone Cedar Valley | $84 | 9% |
| Meridian Complete | $84 | 9% |
| Michigan Complete Health | $84 | 9% |
| Nascentia Health Plus | $84 | 9% |
| New Centry Health Careplus | $84 | 9% |
| Osu Prime Care Advantage | $84 | 9% |
| Pace Cny | $84 | 9% |
| Pace Iowa Immanuel Pathways | $84 | 9% |
| Pace Of Southwest Michigan | $84 - $90 | 9% |
| Pace Southeast | $84 | 9% |
| Pace-Trinity Health | $84 | 9% |
| Peak Pace Solutions | $84 | 9% |
| Preferred Care Partners | $84 | 9% |
| Presbyterian Senior Plan | $84 | 9% |
| Provider Partners Health Plan Of Illinois | $84 | 9% |
| Provider Partners Health Plan Of Indiana | $84 | 9% |
| Pruitthealth Premier | $84 | 9% |
| Reliance Community Care Partners Care Resources Pace | $84 | 9% |
| Rx Allwin | $84 | 9% |
| Rx Grane Grnmedd | $84 | 9% |
| Rx Retiree Rx Care | $84 | 9% |
| Scan Health Plan Mcr Ipa Meritage Oon | $84 | 9% |
| Secure Horizons Ma Pffs | $84 | 9% |
| Serenity Pace | $84 | 9% |
| Siouxland Pace | $84 | 9% |
| Solis Health Plans | $84 | 9% |
| Sunnyview-Pace Finance Dept | $84 | 9% |
| Texan Plus | $84 | 9% |
| The Health Plan | $84 | 9% |
| Thome Pace | $84 | 9% |
| Todays Options | $84 | 9% |
| Tribute Health Plans | $84 | 9% |
| Um Health Advantage | $84 | 9% |
| Union Health Service | $84 | 9% |
| UnitedHealthcare | $84 - $3,742 | 9% |
| Welbe Health | $84 | 9% |
| Wellmed | $84 | 9% |
| Evercare | $86 | 9% |
| Veterans Administration | $86 | 9% |
| Champva | $89 | 9% |
| Tricare | $89 | 9% |
| Triwest Health Alliance | $89 | 9% |
| Us Family Health Plan | $89 | 9% |
| Veterans Eval Services | $89 | 9% |
| Albany County Correctional Facility | $90 | 9% |
| Ambetter / Centene | $90 - $1,790 | 9% |
| Amish Mennonite | $90 | 9% |
| Ascension St. Vincent Public Safety Medical | $90 | 9% |
| Bcccp-Michigan | $90 | 9% |
| Bccp | $90 | 9% |
| Bmc Healthnet | $90 | 9% |
| Breast Grant-Connecticut | $90 | 9% |
| Broward County Dept Of Health | $90 | 9% |
| California Health And Wellness | $90 | 9% |
| Cardinal Innovations Lme | $90 | 9% |
| Care Connections Of Northern Iowa | $90 | 9% |
| Care Oregon Ohp | $90 | 9% |
| Cencal Health Plan | $90 | 9% |
| Cenpatico | $90 | 9% |
| Chhuny | $90 | 9% |
| Childrens Comm Health Plan | $90 | 9% |
| Childrens Medical Services Title 19 | $90 | 9% |
| City Of Philadelphia | $90 | 9% |
| Cmh Allegan County | $90 | 9% |
| Cmh Ausable Valley | $90 | 9% |
| Cmh Barry County | $90 | 9% |
| Cmh Bay-Arenac County | $90 | 9% |
| Cmh Berrien County | $90 | 9% |
| Cmh Cass County | $90 | 9% |
| Cmh Central Mi County | $90 | 9% |
| Cmh Clinton-Eaton-Ingham County | $90 | 9% |
| Cmh Detroit Wayne Integrated Health Network | $90 | 9% |
| Cmh Genesee County | $90 | 9% |
| Cmh Ionia County | $90 | 9% |
| Cmh Jackson County/Lifeways | $90 | 9% |
| Cmh Kalamazoo | $90 | 9% |
| Cmh Kent County | $90 | 9% |
| Cmh Lenawee County | $90 | 9% |
| Cmh Livingston County | $90 | 9% |
| Cmh Macomb | $90 | 9% |
| Cmh Misc | $90 | 9% |
| Cmh Monroe County | $90 | 9% |
| Cmh Montcalm County | $90 | 9% |
| Cmh Muskegon County | $90 | 9% |
| Cmh Newaygo County | $90 | 9% |
| Cmh North Country | $90 | 9% |
| Cmh Northern Lakes County | $90 | 9% |
| Cmh Oakland County | $90 | 9% |
| Cmh Ottawa County | $90 | 9% |
| Cmh Van Buren County | $90 | 9% |
| Cmh Washtenaw County | $90 | 9% |
| Cmh Wayne County/Carelink | $90 | 9% |
| Cmh Wayne Cty/Com Liv Svcs | $90 | 9% |
| Cmh West Mi County | $90 | 9% |
| Community Benefit Health | $90 | 9% |
| Community Care Behavorial Health | $90 | 9% |
| Community Care Partners | $90 | 9% |
| Connections Csp | $90 | 9% |
| County Coroner | $90 | 9% |
| County Funding Generic | $90 | 9% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $90 | 9% |
| Dean Wi Badgercare | $90 | 9% |
| Delaware County Department Of Health | $90 | 9% |
| Delaware First Health | $90 | 9% |
| Delta Dental Nj | $90 | 9% |
| Dph Tb Program | $90 | 9% |
| Dscc | $90 | 9% |
| Eastpointe Lme | $90 | 9% |
| Family Health Network | $90 | 9% |
| Freedom First Healthcare | $90 | 9% |
| Fresno County Ccs | $90 | 9% |
| Ghc Scw Wi Badgercare | $90 | 9% |
| Harbor Health | $90 | 9% |
| Health Safety Net | $90 | 9% |
| Healthy Blue Ne | $90 | 9% |
| Hennepin Health | $90 | 9% |
| Id County Ada | $90 | 9% |
| Id County Canyon | $90 | 9% |
| Id County Cat Fund | $90 | 9% |
| Id County Other | $90 | 9% |
| Id County Payette | $90 | 9% |
| Idaho Dept Health And Wellfare | $90 | 9% |
| Idaho Womens Health Check | $90 | 9% |
| Indiana Breast Cervical Cancer | $90 | 9% |
| Inland Empire Health Plan | $90 | 9% |
| Intercommunity Health Ohp | $90 | 9% |
| Iowa Total Care | $90 | 9% |
| Jai Medical System | $90 | 9% |
| Kern Family Health Plan | $90 | 9% |
| La Care Health Plan | $90 | 9% |
| Lakeland Care Inc | $90 | 9% |
| Managed Health Services - Indiana | $90 | 9% |
| Maryland Breast & Cervical Program | $90 | 9% |
| Maryland Healthy Smiles - Scion Dental | $90 | 9% |
| Maryland Physicians Care | $90 | 9% |
| Massachusetts Behavioral Health Partnership | $90 | 9% |
| Mdwise | $90 | 9% |
| Medi-Cal | $90 | 9% |
| Medi-Cal Healthnet | $90 | 9% |
| Medstar Dc Healthy Family | $90 | 9% |
| Medstar Md Health Choice | $90 | 9% |
| Mo Home State Health Plan | $90 | 9% |
| Molina Centennial Care | $90 | 9% |
| Nascentia Health Options | $90 | 9% |
| Nebraska Total Care | $90 | 9% |
| New York Cancer Services Program | $90 | 9% |
| Nextlevel Health | $90 | 9% |
| Oregon Screenwise | $90 | 9% |
| Paramount Advantage | $90 | 9% |
| Parkland Community Health Plan | $90 | 9% |
| Partners Behavioral Lme | $90 | 9% |
| Peach State Healthplan | $90 | 9% |
| Philadelphia County Funding | $90 | 9% |
| Presbyterian Centennial Care | $90 | 9% |
| Prestige Health Choice | $90 | 9% |
| Priority Partners | $90 | 9% |
| Robert F Sing Program | $90 | 9% |
| Rx 340B Pass Along | $90 | 9% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $90 | 9% |
| Rx Medi-Cal | $90 | 9% |
| Rx Meridian Rx | $90 | 9% |
| Ryan White Florida Mssrp | $90 | 9% |
| Sandhills Center Lme | $90 | 9% |
| Screening For Life | $90 | 9% |
| St Joseph County Hlth Dpt | $90 | 9% |
| Stephenson Cty Health | $90 | 9% |
| Sunshine State Health Plan | $90 | 9% |
| Superior Health | $90 | 9% |
| Tenncare | $90 | 9% |
| Texas Children'S Health Plan | $90 | 9% |
| Trillium Community Ohp | $90 | 9% |
| Tufts Health Public Plans | $90 | 9% |
| Vaya Health Lme | $90 | 9% |
| Washtenaw Health Plan | $90 | 9% |
| Wellsense Health Plan | $90 | 9% |
| Wi Womens Wellness | $90 | 9% |
| Andrie Inc | $97 | 10% |
| East Greenbush Central School District | $97 | 10% |
| Genex Wc | $97 | 10% |
| Healthsmart Workers Comp | $97 | 10% |
| Jag Source | $97 | 10% |
| New York State Insurance Fund | $97 | 10% |
| Njm Insurance Group | $97 | 10% |
| Rx Heatlhcomp | $97 | 10% |
| Rx Restat | $97 | 10% |
| Rx Saif Opdp Wc | $97 | 10% |
| Rx Worker'S Comp | $97 | 10% |
| Wc Accident Fund | $97 | 10% |
| Wc Ace | $97 | 10% |
| Wc Acs Federal Employees | $97 | 10% |
| Wc Acuity | $97 | 10% |
| Wc Advantage | $97 | 10% |
| Wc Aegis | $97 | 10% |
| Wc Aig | $97 | 10% |
| Wc Aims | $97 | 10% |
| Wc Alaska National Ins | $97 | 10% |
| Wc Align Network | $97 | 10% |
| Wc Allied | $97 | 10% |
| Wc Am Trust N America | $97 | 10% |
| Wc American Claims Mgmt | $97 | 10% |
| Wc Amerisure | $97 | 10% |
| Wc Amtrust | $97 | 10% |
| Wc Asu Risk Mgt | $97 | 10% |
| Wc Benetech | $97 | 10% |
| Wc Berkley Admin | $97 | 10% |
| Wc Broadspire | $97 | 10% |
| Wc Broward County | $97 | 10% |
| Wc Bunch & Associates | $97 | 10% |
| Wc California State Comp Ins | $97 | 10% |
| Wc California State Ins Fund | $97 | 10% |
| Wc Capitol Area Health Consortium | $97 | 10% |
| Wc Ccmsi | $97 | 10% |
| Wc Chartis | $97 | 10% |
| Wc Chubb | $97 | 10% |
| Wc Cirma | $97 | 10% |
| Wc City Of Albany | $97 | 10% |
| Wc City Of Sioux City | $97 | 10% |
| Wc Claims Mgmt Inc | $97 | 10% |
| Wc Cna | $97 | 10% |
| Wc Comp One Admin C/O Manageability | $97 | 10% |
| Wc Compone Admin | $97 | 10% |
| Wc Corvel | $97 | 10% |
| Wc Ct Healthcare Trust | $97 | 10% |
| Wc Donegal Insurance Group | $97 | 10% |
| Wc Emc Insurance Company | $97 | 10% |
| Wc Employee Mutual | $97 | 10% |
| Wc Enablecomp | $97 | 10% |
| Wc Encore Health Network | $97 | 10% |
| Wc Erie | $97 | 10% |
| Wc Esis | $97 | 10% |
| Wc Evolutions | $97 | 10% |
| Wc Fcci | $97 | 10% |
| Wc Fed Ex | $97 | 10% |
| Wc Federal Black Lung | $97 | 10% |
| Wc Federated | $97 | 10% |
| Wc Finley Occupational Health | $97 | 10% |
| Wc First Agency/Occunet | $97 | 10% |
| Wc Ford Motor | $97 | 10% |
| Wc Fresno Unified Emp | $97 | 10% |
| Wc Gallagher Bassett | $97 | 10% |
| Wc General Motors | $97 | 10% |
| Wc Generic | $97 | 10% |
| Wc Genex Care For Ohio | $97 | 10% |
| Wc Great West Casualty | $97 | 10% |
| Wc Guarantee Insurance | $97 | 10% |
| Wc Guard Insurance Company | $97 | 10% |
| Wc Hab | $97 | 10% |
| Wc Hartford | $97 | 10% |
| Wc Hastings | $97 | 10% |
| Wc Health Management | $97 | 10% |
| Wc Heritage Summit | $97 | 10% |
| Wc Hireright | $97 | 10% |
| Wc Horizon | $97 | 10% |
| Wc Icw Group | $97 | 10% |
| Wc Idaho State Ins Fund | $97 | 10% |
| Wc Intercare Insurance | $97 | 10% |
| Wc Intermountain | $97 | 10% |
| Wc Johns Eastern | $97 | 10% |
| Wc Kemberton | $97 | 10% |
| Wc Key Ins & Benefit Solutions | $97 | 10% |
| Wc Liberty Mutual | $97 | 10% |
| Wc Mac Risk Management | $97 | 10% |
| Wc Massachusetts | $97 | 10% |
| Wc Mdia | $97 | 10% |
| Wc Meadowbrook Claim | $97 | 10% |
| Wc Medical Administrators | $97 | 10% |
| Wc Meijers | $97 | 10% |
| Wc Memic | $97 | 10% |
| Wc Mercy Workcare | $97 | 10% |
| Wc Michigan | $97 | 10% |
| Wc Michigan Millers Mutual | $97 | 10% |
| Wc Mitchell Frankenmuth | $97 | 10% |
| Wc Mra | $97 | 10% |
| Wc Nationwide | $97 | 10% |
| Wc Nca Comp | $97 | 10% |
| Wc New York | $97 | 10% |
| Wc New York Special Funds | $97 | 10% |
| Wc North American Rishces | $97 | 10% |
| Wc Northeast Health | $97 | 10% |
| Wc Notre Dame | $97 | 10% |
| Wc Novanet | $97 | 10% |
| Wc O'Hara Corp | $97 | 10% |
| Wc Occ Health Allen | $97 | 10% |
| Wc Ohio Bureau | $97 | 10% |
| Wc One Call Medical | $97 | 10% |
| Wc Paradigm | $97 | 10% |
| Wc Peerless | $97 | 10% |
| Wc Pma | $97 | 10% |
| Wc Praxis Health Network | $97 | 10% |
| Wc Price Chopper | $97 | 10% |
| Wc Procura Management | $97 | 10% |
| Wc Qualcare | $97 | 10% |
| Wc Quiktrip | $97 | 10% |
| Wc Reny Company | $97 | 10% |
| Wc Rev Claims | $97 | 10% |
| Wc Risico | $97 | 10% |
| Wc Rural Mutual | $97 | 10% |
| Wc Saif Oregon | $97 | 10% |
| Wc Secura | $97 | 10% |
| Wc Sedgwick | $97 | 10% |
| Wc Sentry | $97 | 10% |
| Wc Sheakley Unicomp | $97 | 10% |
| Wc Smile Lodge | $97 | 10% |
| Wc Society | $97 | 10% |
| Wc Srs | $97 | 10% |
| Wc Taconic (Mro) | $97 | 10% |
| Wc Taconic Farms | $97 | 10% |
| Wc Travelers | $97 | 10% |
| Wc Triad Group | $97 | 10% |
| Wc Tristar | $97 | 10% |
| Wc Troy Ny | $97 | 10% |
| Wc Tyson | $97 | 10% |
| Wc Unified Health Services | $97 | 10% |
| Wc United Heartland | $97 | 10% |
| Wc Us Dept Of Labor | $97 | 10% |
| Wc Velocity | $97 | 10% |
| Wc Walmart | $97 | 10% |
| Wc West Bend | $97 | 10% |
| Wc West Bend Mutual/Argent | $97 | 10% |
| Wc Winnebago Industries | $97 | 10% |
| Wc Yankee Trails | $97 | 10% |
| Wc York Risk | $97 | 10% |
| Wc Zenith | $97 | 10% |
| Wc Zurich | $97 | 10% |
| Health America Advantra | $103 - $1,203 | 11% |
| Prime Healthcare | $111 - $1,805 | 12% |
| Health Partners | $114 | 12% |
| Jefferson Health Plan Commercial | $114 - $1,825 | 12% |
| Amerihealth | $122 - $2,213 | 13% |
| Bcn Domestic | $122 | 13% |
| Blue Benefit Administrators Of Massachusetts | $122 | 13% |
| Blue Care Network | $122 | 13% |
| Blue Distinction Transplant | $122 | 13% |
| Blue Shield - Ca | $122 - $2,213 | 13% |
| Blue Shield - Id (Regence) | $122 - $2,213 | 13% |
| Blue Shield - Ny Highmark Northeastern | $122 | 13% |
| Blue Shield - Ny Highmark Western | $122 - $2,213 | 13% |
| Blue Shield - Pa (Highmark) | $122 - $2,711 | 13% |
| Blue Shield - Wa (Regence) | $122 - $2,213 | 13% |
| Health Choices | $122 | 13% |
| Kaiser Domestic | $122 | 13% |
| Pre-Employment | $122 | 13% |
| Wc Domestic | $122 | 13% |
| Oscar | $127 - $1,805 | 13% |
| Multiplan | $133 | 14% |
| Geha | $135 - $3,742 | 14% |
| Homestead Health Plans Woods Center | $167 - $1,955 | 18% |
| Group Pension Administrators | $192 - $2,256 | 20% |
| Reedman Toll | $192 - $2,256 | 20% |
| Coventry | $215 | 23% |
| Health America | $215 | 23% |
| Meritain | $215 | 23% |
| Devon Health Services | $428 | 45% |
| First Health | $428 | 45% |
| Prime Health Services | $451 | 47% |
| Three Rivers Provider Network | $451 | 47% |
| Keystone First | $2,581 | 272% |
| Keystone First Chip | $2,581 | 272% |
| Upmc Health Plan | $4,432 | 466% |
| Webtpa | $4,432 | 466% |