CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: University of Texas M. D. Anderson Cancer Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $2,173
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.29x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at University of Texas M. D. Anderson Cancer Center is $2,173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 2.29x the Medicare baseline. Located in 1515 Holcombe Blvd, Houston, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,173

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%)

Insurance Median: $2,173 (229%)

Ins. Median: $2,173 (229% 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 229% of the Medicare baseline (a markup of 129%). 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
Texaschildrens	$134 - $1,366	14%
Tricare	$157 - $2,328	17%
Vacare	$157 - $1,495	17%
Medicare (plans)	$222 - $1,366	23%
UnitedHealthcare	$255 - $2,328	27%
Blue Cross Blue Shield	$321 - $2,235	34%
Aetna	$404 - $2,328	43%
Cigna	$411 - $2,328	43%
Humana	$1,103 - $2,390	116%
Ontarioministriesofhealth	$1,360 - $2,297	143%
Beijingst.Lucia	$1,378 - $2,328	145%
Embassyofqatar	$1,378 - $2,328	145%
Memorialhermannhealth	$1,378 - $2,328	145%
Emergingtherapysolutions_Cancercare	$1,470 - $2,483	155%
Interlink_Cancercare	$1,470 - $2,483	155%
Saudiarmedforces	$1,470 - $2,483	155%
Uae_Medical	$1,470 - $2,483	155%
Uaepoliceattache	$1,470 - $2,483	155%
Healthsmart	$1,562 - $2,638	164%
Vantage	$1,562 - $2,638	164%
Multiplan	$1,593 - $2,669	168%
Phcs	$1,593 - $2,669	168%
Emergingtherapysolutions	$2,328 - $2,483	245%
Interlink	$2,328 - $2,638	245%

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 $X.
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 University of Texas M. D. Anderson Cancer Center 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.