CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Christus Santa Rosa Hospital-San Marcos

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $906
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Christus Santa Rosa Hospital-San Marcos is $906. 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 0.95x the Medicare baseline. Located in 1301 Wonder World Drive, San Marcos, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$906

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: $906 (95%)
Ins. Median: $906 (95% 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
Community First $328 35%
Blue Cross Blue Shield $335 - $1,917 35%
Amerigroup $345 - $954 36%
Texas Childrens Health Plan $345 36%
UnitedHealthcare $375 - $4,331 39%
Superior $378 40%
Allwell $884 93%
Christus Health $884 - $1,237 93%
Humana $884 - $6,561 93%
Triwest $884 93%
Washington National $884 93%
Wellcare $884 93%
Aetna $901 95%
Cigna $910 - $6,603 96%
Provider Partners Health Plan $910 96%
Shared Health Insurance Company $928 98%
Devoted Health Plan $954 100%
Sendero $1,511 159%
Naphcare Inc. $1,767 186%
Healthcare Highways $2,235 235%
Five Point Credit Union $4,020 423%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1301 Wonder World Drive, San Marcos, TX 78666
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals