CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Geisinger Jersey Shore Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $495
Cash Discount Price: $632
vs. Medicare Baseline: 0.52x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Geisinger Jersey Shore Hospital is $495. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $632. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.52x the Medicare baseline. Located in 1020 Thompson Street, Jersey Shore, PA.

Cash / Self-Pay

$632

Average discount available for prompt cash payment at this facility.

Insurance Median

$495

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: $632 (67%)

Insurance Median: $495 (52%)

Cash: $632 (67% of Medicare)

Ins. Median: $495 (52% 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
Blue Cross Blue Shield	$164 - $605	17%
Medicaid / KanCare	$180	19%
Amerihealth	$199	21%
Geisinger Family Plan	$199	21%
Geisinger Health Plan	$204 - $501	21%
Upmc For You	$212	22%
Health Partners	$217	23%
Upmc Chip	$226	24%
Advantra	$365	38%
Aetna	$365 - $780	38%
American Progressive	$365	38%
Medicare (plans)	$365	38%
Humana	$368	39%
UnitedHealthcare	$453	48%
Cigna	$490	52%
Christian Healthcare Ministries	$510	54%
Medical Development International	$714	75%
Integrated Health Plan	$765	81%
Prime Health Services	$765	81%
Multiplan	$816	86%
Ambetter / Centene	$875	92%
Prison Health Services	$1,083	114%

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 $632.
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 Geisinger Jersey Shore 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.