CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Methodist Hospitals of Memphis

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $835
Cash Discount Price: $1,587
vs. Medicare Baseline: 0.88x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Methodist Hospitals of Memphis is $835. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,587. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.88x the Medicare baseline. Located in 1265 Union Ave Suite 700, Memphis, TN.

Cash / Self-Pay

$1,587

Average discount available for prompt cash payment at this facility.

Insurance Median

$835

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: $1,587 (167%)

Insurance Median: $835 (88%)

Cash: $1,587 (167% of Medicare)

Ins. Median: $835 (88% 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
Medicaid / KanCare	$250 - $677	26%
Blue Cross Blue Shield	$564 - $835	59%
Molina Healthcare [350012]	$677 - $846	71%
UnitedHealthcare	$677 - $2,383	71%
Tricare	$818	86%
American Health Advantage Mcr Adv [450117]	$835	88%
Carecentrix [450200]	$835	88%
Generic Hospice Vbid [10940000101]	$835	88%
Humana	$835	88%
Medicare (plans)	$835	88%
Va Hospital [600005]	$835	88%
Devoted Health [450111]	$860	91%
Select Specialty Hospital [100298]	$1,085	114%
Cigna	$1,237 - $1,743	130%
United Food & Commercial Workers [100309]	$1,743	183%
Langston Performance Health [100405]	$3,463	364%

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 $1,587.
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 Methodist Hospitals of Memphis 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.