CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: UT of Texas Southwestern University Hospital - William P. Clements Jr.

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,021
Cash Discount Price: $1,288
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at UT of Texas Southwestern University Hospital - William P. Clements Jr. is $1,021. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,288. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.07x the Medicare baseline. Located in 6201 Harry Hines Blvd, Dallas, TX.

Cash / Self-Pay

$1,288

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,021

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: $1,288 (136%)

Insurance Median: $1,021 (107%)

Cash: $1,288 (136% of Medicare)

Ins. Median: $1,021 (107% 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
Procare	$89 - $912	9%
Ambetter / Centene	$91 - $181	10%
Blue Cross Blue Shield	$93 - $3,375	10%
Humana	$93 - $948	10%
Superior	$98 - $957	10%
Wellpoint	$98 - $957	10%
Molina	$104 - $957	11%
Parkland	$146 - $328	15%
UnitedHealthcare	$146 - $4,145	15%
Aetna	$168 - $2,112	18%
Healthfirst	$174 - $2,453	18%
Quiktrip	$200 - $2,749	21%
Coventry	$289 - $3,050	30%
Maestro Health/Fort Worth Firefighters	$378 - $2,333	40%
United Options Nexus	$533 - $6,261	56%
Healthsmart	$629 - $3,622	66%
Cigna	$682 - $3,214	72%
Rockwall County	$972 - $3,055	102%
Galaxy Health Network	$1,249 - $3,840	131%
Multiplan	$1,249 - $3,797	131%
Phcs	$1,279 - $3,539	135%

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 $1,288.
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 UT of Texas Southwestern University Hospital - William P. Clements Jr. 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.