CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Lake Granbury Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,046
  • Cash Discount Price: $3,617
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Lake Granbury Medical Center is $1,046. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,617. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.10x the Medicare baseline. Located in 1310 Paluxy Rd, Granbury, TX.
Cash / Self-Pay
$3,617

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,046

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: $3,617 (381%)
Insurance Median: $1,046 (110%)
Cash: $3,617 (381% of Medicare)
Ins. Median: $1,046 (110% 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%
Aetna $346 - $13,804 36%
Medicaid / KanCare $346 - $1,306 36%
UnitedHealthcare $346 - $8,542 36%
Amerigroup $363 38%
Healthspring $363 38%
Superior $397 - $2,791 42%
Tricare $887 93%
Node Champva $934 98%
Cigna $1,002 - $7,917 105%
Humana $1,002 105%
Medicare (plans) $1,002 105%
Hospice Non Par $1,019 107%
Node Va $1,019 107%
Triwest $1,019 107%
Blue Cross Blue Shield $1,022 - $5,063 108%
Node Care N Care $1,022 108%
American Health $1,042 110%
Provider Partners Health Plan $1,049 110%
Node Amerigroup Mcr Adv $1,052 111%
Self Pay $1,206 127%
Node Us Dept Of Labor $1,273 134%
Node Brookshire Brothers $1,783 188%
93% Payors Work Comp Tx $1,895 199%
Node Brookshire Brothers Work Comp Tx $1,895 199%
Work Comp $2,037 214%
Healthsmart $11,051 - $14,065 1163%
Multiplan $15,070 - $17,682 1586%
Santa Fe Hospital Association $16,074 1692%
Galaxy Health $19,088 2009%
Medcorp Southwest $19,088 2009%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1310 Paluxy Rd, Granbury, TX 76048
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals