CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: De Tar Hospital Navarro

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $964
  • Cash Discount Price: $4,263
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at De Tar Hospital Navarro is $964. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,263. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.01x the Medicare baseline. Located in 506 E San Antonio St, Victoria, TX.
Cash / Self-Pay
$4,263

Average discount available for prompt cash payment at this facility.

Insurance Median
$964

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: $4,263 (449%)
Insurance Median: $964 (101%)
Cash: $4,263 (449% of Medicare)
Ins. Median: $964 (101% 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
Veterans Eval Services $315 33%
Medicaid / KanCare $346 - $3,838 36%
Scott & White $346 36%
UnitedHealthcare $346 - $5,786 36%
Blue Cross Blue Shield $352 - $4,243 37%
Amerigroup $816 86%
Tricare $887 - $934 93%
Humana $919 97%
Medicare (plans) $919 97%
Department Of Veterans Affairs $934 98%
Node Hospice Non Par Agree $934 98%
Node Triwest $934 98%
Node Va $934 98%
Aetna $947 - $11,571 100%
American Health Mcr Adv $956 101%
Provider Partners Health Plan $962 101%
Node Amerigroup Mcr Adv $965 102%
Node Procare Mcr Adv $965 102%
Superior $965 - $2,417 102%
Multiplan $1,013 - $16,241 107%
Industrial Rehab $1,074 113%
Node Us Dept Of Labor $1,168 123%
Node Brookshire Brothers $1,635 172%
Node Brookshire Brothers Work Comp Tx $1,738 183%
Work Comp $1,868 197%
Elap $2,055 216%
Dars $4,669 491%
Tx Workforce Commission $4,669 491%
Cigna $4,832 - $8,729 509%
Healthsmart $11,165 - $14,211 1175%
First Health $13,805 1453%
Medcorp Southwest Inc $14,211 1496%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 506 E San Antonio St, Victoria, TX 77901
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals