CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Memorial Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $331
  • Cash Discount Price: $260
  • vs. Medicare Baseline: 0.35x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Memorial Medical Center is $331. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $260. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.35x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$260

Average discount available for prompt cash payment at this facility.

Insurance Median
$331

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: $260 (27%)
Insurance Median: $331 (35%)
Cash: $260 (27% of Medicare)
Ins. Median: $331 (35% 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
Ambetter / Centene $103 - $277 11%
Triwest Va Pccc-All Plans $158 - $212 17%
Amerigroup Mcr Adv-All Other Plans $161 - $216 17%
Care Improvement Plus - All Other Plans $161 - $216 17%
Care Improvement Plus Mcr $161 - $218 17%
Superior Allwell Mcr Adv-All Other Plans $161 - $216 17%
UnitedHealthcare $161 - $865 17%
Universal American Mcr-All Other Plans $161 - $216 17%
Universal American Snp $169 - $227 18%
Coventry First Hlth Hmo Ppo-All Other Plans $201 - $692 21%
Coventry First Hlth Mcr Adv $201 - $216 21%
Healthcare Highways-All Plans $210 - $692 22%
Multiplan Mcr Adv $216 - $735 23%
Prime Healthcare Services-All Plans $226 - $606 24%
Galaxy Health Network-All Plans $234 - $735 25%
Blue Cross Blue Shield $242 - $908 25%
Humana $258 - $692 27%
Corvel Work Comp-All Plans $275 - $735 29%
Independent Med Sys Ppo-All Plans $275 - $735 29%
Multiplan Phcs Ppo-All Other Plans $275 - $735 29%
Provider Select Ppo-All Plans $275 - $735 29%
Three Rivers Ppo-All Plans $275 - $735 29%
Usa Mso - All Plans $275 - $735 29%
Capstar Health Network-All Plans $301 - $692 32%
Cigna $301 32%
Amerigroup Chip $323 - $865 34%
Amerigroup Star $323 - $865 34%
Amerigroup Star Kids $323 - $865 34%
Amerigroup Star Plus $323 - $865 34%
Comm Health Chip $323 - $865 34%
Comm Health Perinatal-All Other Plans $323 - $865 34%
Molina Chip/Star-All Plans $323 - $865 34%
Scott & White Chip/Star-All Plans $323 - $865 34%
Superior Chip/Star $323 - $865 34%
Texas Childrens Hp - All Plans $323 - $865 34%
Comm Health Mcaid Hmo $339 - $908 36%
Comm Health Star $339 - $908 36%
Aetna $692 73%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N Virginia St, Port Lavaca, TX 77979
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals