CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Texas Health Arlington Memorial Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,994
Cash Discount Price: $1,859
vs. Medicare Baseline: 2.10x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Texas Health Arlington Memorial Hospital is $1,994. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,859. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 2.10x the Medicare baseline. Located in 800 W Randol Mill Rd, Arlington, TX.

Cash / Self-Pay

$1,859

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,994

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: $1,859 (196%)

Insurance Median: $1,994 (210%)

Cash: $1,859 (196% of Medicare)

Ins. Median: $1,994 (210% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 210% of the Medicare baseline (a markup of 110%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Amerigroup	$328 - $983	35%
Blue Cross Blue Shield	$328 - $6,383	35%
Cook Childrens	$328	35%
Parkland	$328	35%
UnitedHealthcare	$328 - $3,751	35%
Superior Wellcare	$345 - $1,029	36%
Molina	$355 - $983	37%
Aetna	$361 - $2,219	38%
American Health	$936	99%
Healthspring	$954	100%
Humana	$973	102%
City Of Fort Worth	$1,424 - $1,488	150%
Fort Worth Firefighters	$1,583 - $2,319	167%
Cigna	$1,675 - $2,978	176%
Quick Trip	$1,818 - $1,994	191%
Phcs	$2,106 - $2,358	222%
Healthsmart	$2,273 - $2,659	239%
Multiplan	$2,637 - $2,754	278%
Galaxy	$2,667 - $2,785	281%
Usa	$2,667 - $2,785	281%

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 $1,859.
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 Texas Health Arlington Memorial Hospital 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.