CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Dunes Surgical Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,402
Cash Discount Price: $1,399
vs. Medicare Baseline: 1.48x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Dunes Surgical Hospital is $1,402. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,399. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.48x the Medicare baseline. Located in 600 N Sioux Point Road, Dakota Dunes, SD.

Cash / Self-Pay

$1,399

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,402

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: $1,399 (147%)

Insurance Median: $1,402 (148%)

Cash: $1,399 (147% of Medicare)

Ins. Median: $1,402 (148% 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
UnitedHealthcare	$372 - $1,936	39%
Ne Total Care	$933	98%
Siouxland Pace	$933	98%
Ia Total Care	$951	100%
Wellpoint	$951	100%
Molina	$961	101%
Amerigroup	$964	101%
Oscar	$1,110	117%
Cigna	$1,694	178%
Midlands Choice	$1,694	178%
Blue Cross Blue Shield	$1,705	179%
Avera Health Plans	$1,815	191%
Multiplan	$1,815	191%
Accountable Healthplan	$2,057	217%
Sanford Health Plan	$2,057	217%
Health Partners	$2,347	247%

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 $1,399.
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 Dunes Surgical 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.