CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Erlanger Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $314
  • Cash Discount Price: $244
  • vs. Medicare Baseline: 0.33x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Erlanger Medical Center is $314. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $244. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.33x the Medicare baseline. Located in 975 E 3Rd St, Chattanooga, TN.
Cash / Self-Pay
$244

Average discount available for prompt cash payment at this facility.

Insurance Median
$314

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: $244 (26%)
Insurance Median: $314 (33%)
Cash: $244 (26% of Medicare)
Ins. Median: $314 (33% 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
UnitedHealthcare $48 - $2,871 5%
Amerigroup $55 - $511 6%
Cigna $62 - $836 7%
Devoted Health $68 - $870 7%
Humana $75 - $836 8%
Atrio Health $82 - $920 9%
Point Comfort Underwriters $82 - $430 9%
Alexian $89 - $836 9%
Pruitthealth Premier $96 - $255 10%
Blue Cross Blue Shield $239 - $836 25%
Bluecare $239 - $870 25%
Clover $239 - $836 25%
Medicare (plans) $239 25%
Upmc $239 - $836 25%
Aetna $240 - $861 25%
American Health $246 - $861 26%
Nhc $251 - $878 26%
Simpra Advantage $263 28%
Caresource $291 - $1,673 31%
Peach State Hlth Plan $291 31%
Ambetter / Centene $299 - $1,045 31%
Bluecard - Network S $300 - $510 32%
Bluecard - Network P $318 - $510 33%
Caresource Ga $335 - $600 35%
Caresource Tn $335 - $600 35%
Olympus $359 - $407 38%
Alliant $383 - $813 40%
Caresource Nc $404 - $600 43%
Occunet $419 - $795 44%
Pnoa $462 - $2,091 49%
Wellpoint $780 82%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 E 3Rd St, Chattanooga, TN 37403
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals