CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Harlingen Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $958
  • Cash Discount Price: $929
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Harlingen Medical Center is $958. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $929. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.01x the Medicare baseline. Located in 5501 South Expressway 77, Harlingen, TX.
Cash / Self-Pay
$929

Average discount available for prompt cash payment at this facility.

Insurance Median
$958

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: $929 (98%)
Insurance Median: $958 (101%)
Cash: $929 (98% of Medicare)
Ins. Median: $958 (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
Aetna $930 - $1,161 98%
Blue Cross Blue Shield $930 - $1,092 98%
Careworks Worker Compensation Fka Rockport Community Network $930 98%
Cigna $930 - $958 98%
Humana $930 98%
Medicare (plans) $930 98%
San Benito Medical Associates $930 98%
Superior Health Plan $930 98%
Texas Bluebonnett Health Plan $930 - $1,534 98%
Tricare $930 98%
UnitedHealthcare $930 - $2,997 98%
Veterans Evaluation Services $930 98%
Wellmed $930 98%
Workers Compensation $930 98%
Molina $976 - $1,441 103%
Provider Partners Health Plan $976 103%
Imperial Insurance Company $985 104%
Asserta Health $1,208 127%
Friday Health Plan $1,208 127%
Magic Valley Electric Cooperative $1,208 127%
Superior Health Commercial Exchange $1,208 127%
Employer Direct Healthcare $1,301 137%
Corporate Remedies Worker Compensation $1,394 147%
Naphcare $1,441 152%
Baker Benefits Administrators $1,859 196%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5501 South Expressway 77, Harlingen, TX 78550
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals