CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Tennova Healthcare - Clarksville

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,267
  • Cash Discount Price: $1,640
  • vs. Medicare Baseline: 1.33x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Tennova Healthcare - Clarksville is $1,267. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,640. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.33x the Medicare baseline. Located in 651 Dunlop Lane, Clarksville, TN.
Cash / Self-Pay
$1,640

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,267

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: $1,640 (173%)
Insurance Median: $1,267 (133%)
Cash: $1,640 (173% of Medicare)
Ins. Median: $1,267 (133% 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
Veterans Eval Services $300 32%
Amerigroup $607 64%
Blue Cross Blue Shield $862 - $2,522 91%
Tricare $876 92%
Cigna $886 - $1,986 93%
Medicaid / KanCare $886 - $2,114 93%
UnitedHealthcare $886 - $2,179 93%
Humana $907 - $1,860 95%
Medicare (plans) $907 95%
Node Windsor Mcr Dual $907 95%
Node Devoted Health Mcr Adv $921 97%
Node Bluecare Plus Tn Mcr Adv $922 97%
Node Champva $922 97%
Node Hospice Non Par Agree $922 97%
Node Va $922 97%
Node Wellcare Mcr Adv $922 97%
American Health $925 97%
Node Ascension Complete Mcr Adv $925 97%
Node Farm Bureau Mcr Adv $925 97%
Node Healthspring Mcr Adv $925 97%
Aetna $934 - $1,911 98%
Node Amerigroup Mcr Adv $952 100%
Node Nhc Mcr Adv $998 105%
Node Us Dept Of Labor $1,152 121%
Corvel $1,299 137%
Rockport Work Comp Tn $1,299 137%
Novanet Work Comp Tn $1,340 141%
Prime Health Work Comp Tn $1,340 141%
Tn Work Comp $1,368 144%
Ky Work Comp $1,604 169%
Self Pay $1,640 173%
Ambetter / Centene $1,705 179%
Node Valenz Access $1,843 194%
Naphcare $2,074 218%
Wellcare $2,114 223%
Multiplan $2,392 252%
Center Care $5,496 578%
Oscar $7,193 757%
Correct Care Solutions $7,610 801%
First Health $7,610 801%
Phcs $8,032 845%
Prime Health Services $8,032 845%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 Dunlop Lane, Clarksville, TN 37040
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals