CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Ascension Seton Southwest

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $884
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Ascension Seton Southwest is $884. 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 0.93x the Medicare baseline. Located in 7900 Fm 1826, Austin, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$884

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: $884 (93%)
Ins. Median: $884 (93% 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
Champva $188 - $193 20%
Blue Cross Blue Shield $328 - $894 35%
Dell Chip/Chip Perinate $328 35%
Dell Star $328 35%
UnitedHealthcare $328 - $901 35%
Wellpoint Chip/Chip Perinate $328 35%
Wellpoint Star $328 35%
Wellpoint Star Kids $328 35%
Wellpoint Star Plus $328 35%
Tricare $727 - $884 77%
Aarp Mc Wellmed $866 91%
Sendero Chap $875 92%
Addr Cancer Together $884 93%
Aetna $884 93%
Covid Hrsa $884 93%
Cshcn Cidc $884 93%
Devoted Health Mcr Replacement $884 93%
Humana $884 - $969 93%
Medicare (plans) $884 93%
Research Study $884 93%
Smarthealth $884 93%
Superior Allwell $884 93%
Wellcare Med Advantage $884 93%
Connected Senior Care $910 96%
Pphp Mcr Advantage $928 98%
Tx Independence Hp $928 98%
Oscar Health Exchange $1,000 105%
Occunet $1,237 130%
Sendero Idealcare $1,546 163%
Ambetter / Centene $1,590 167%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7900 Fm 1826, Austin, TX 78737
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals