CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Cannon Memorial Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $167
  • Cash Discount Price: $125
  • vs. Medicare Baseline: 0.18x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Cannon Memorial Hospital is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $125. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.18x the Medicare baseline. Located in 123 W G Acker Drive, Pickens, SC.
Cash / Self-Pay
$125

Average discount available for prompt cash payment at this facility.

Insurance Median
$167

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: $125 (13%)
Insurance Median: $167 (18%)
Cash: $125 (13% of Medicare)
Ins. Median: $167 (18% 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.

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
Medicaid / KanCare $61 - $157 6%
Absolute Total Care [58] $62 - $160 7%
Humana $64 - $1,022 7%
Select Health Of Sc [637] $64 - $140 7%
Aetna $83 - $267 9%
Blue Choice Health Plan [922] $83 - $429 9%
Blue Cross Blue Shield $83 - $429 9%
Devoted Health Alt Payer [9401] $83 - $170 9%
Devoted Health [94] $83 - $170 9%
Medicare (plans) $83 - $192 9%
UnitedHealthcare $83 - $300 9%
Vaccn - Va Community Care Network [16] $83 - $167 9%
Veterans Administration [633] $83 - $167 9%
Absolute Total Care Mcr Plans Alt Payer [4101] $86 - $173 9%
Absolute Total Care Mcr Plans [41] $86 - $173 9%
Cigna $86 - $322 9%
Molina Dual Options Alt Payer [1501] $86 - $172 9%
Molina Dual Options [15] $86 - $172 9%
Champva [604] $87 - $174 9%
Tricare $87 - $174 9%
First Choice Vip Careplus Alt Payer [3301] $88 - $175 9%
First Choice Vip [33] $88 - $175 9%
Nhc Advantage Alt Payer [6101] $88 - $175 9%
Nhc Advantage [61] $88 - $175 9%
Bright Health Alt Payer [1001] $89 - $192 9%
Bright Health [11] $118 - $237 12%
Ambetter / Centene $119 - $238 13%
Employee Benefit Management Services [869] $120 - $240 13%
First Choice Next [96] $121 - $242 13%
Molina Marketplace [97] $121 - $242 13%
Mail Handlers Benefit Plan [327] $133 - $267 14%
Rural Carrier Benefit Plan [406] $133 - $267 14%
Workers Compensation [622] $134 - $269 14%
Edison Health Solutions [95] $146 - $292 15%
Healthscope [98] $146 - $292 15%
Geha [302] $150 - $300 16%
Golden Rule Ins Co [584] $150 - $300 16%
Preferred Administrators [19] $150 - $300 16%
Nalc Health Benefit Plan [291] $161 - $322 17%
Medcost [206] $189 - $379 20%
Planned Administrators [886] $215 - $429 23%
Thomas Cooper & Company [315] $215 - $429 23%
Phcs [940] $220 - $440 23%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 123 W G Acker Drive, Pickens, SC 29671
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals