CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Metro Nashville General Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $166
  • Cash Discount Price: $2,347
  • vs. Medicare Baseline: 0.17x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Metro Nashville General Hospital is $166. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,347. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.17x the Medicare baseline. Located in 1818 Albion Street, Nashville, TN.
Cash / Self-Pay
$2,347

Average discount available for prompt cash payment at this facility.

Insurance Median
$166

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: $2,347 (247%)
Insurance Median: $166 (17%)
Cash: $2,347 (247% of Medicare)
Ins. Median: $166 (17% 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 $91 - $166 10%
Corizon $109 11%
Amerigroup $145 15%
Amerivantage $145 15%
Aetna $166 - $2,151 17%
Blue $166 17%
Cigna $166 - $211 17%
Humana $166 17%
Medicare (plans) $166 17%
Upmc $166 17%
Wellcare $166 17%
Farm Bureau $169 18%
Corecivic $183 19%
Ambetter / Centene $233 25%
Naphcare $249 26%
Provider Network Of America $282 30%
Blue Cross Blue Shield $325 - $429 34%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1818 Albion Street, Nashville, TN 37208
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals