CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Tennova Healthcare-Jefferson Memorial Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $872
  • Cash Discount Price: $2,664
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Tennova Healthcare-Jefferson Memorial Hospital is $872. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,664. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.92x the Medicare baseline. Located in 110 Hospital Drive, Jefferson City, TN.
Cash / Self-Pay
$2,664

Average discount available for prompt cash payment at this facility.

Insurance Median
$872

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: $2,664 (280%)
Insurance Median: $872 (92%)
Cash: $2,664 (280% of Medicare)
Ins. Median: $872 (92% 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 $518 55%
Medicaid / KanCare $644 68%
UnitedHealthcare $644 - $12,038 68%
Bluecare $663 - $988 70%
Tricare $802 84%
Humana $830 87%
Medicare (plans) $830 87%
Node Bluecare Plus Tn Mcr Adv $844 89%
Node Champva $844 89%
Node Hospice Non Par Agree $844 89%
Node Va $844 89%
Node Devoted Health Mcr Adv $847 89%
Node Farm Bureau Mcr Adv $847 89%
Aetna $855 - $7,728 90%
Blue Cross Blue Shield $855 - $2,546 90%
Node Healthspring Mcr Adv $855 90%
Node Amerigroup Mcr Adv $872 92%
Node Wellcare Mcr Adv $877 92%
Node Nhc Mcr Adv $913 96%
Node Us Dept Of Labor $1,055 111%
Three Rivers Work Comp Tn $1,094 115%
Novanet Work Comp Tn $1,354 143%
Occunet Work Comp Tn $1,368 144%
Tn Work Comp $1,368 144%
Ambetter / Centene $1,561 164%
Point Comfort Underwriters $1,827 192%
Cigna $1,957 206%
Self Pay $2,664 280%
Multiplan Complementary $9,510 1001%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 110 Hospital Drive, Jefferson City, TN 37760
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals