CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Ward Memorial Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $676
Cash Discount Price: $1,509
vs. Medicare Baseline: 0.71x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Ward Memorial Hospital is $676. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,509. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.71x the Medicare baseline. Located in 406 South Gary St, Monahans, TX.

Cash / Self-Pay

$1,509

Average discount available for prompt cash payment at this facility.

Insurance Median

$676

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: $1,509 (159%)

Insurance Median: $676 (71%)

Cash: $1,509 (159% of Medicare)

Ins. Median: $676 (71% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$126 - $2,552	13%
Firstcare	$126 - $706	13%
Medicare (plans)	$126 - $693	13%
Superior Healthplan	$126 - $693	13%
Cigna	$388 - $2,129	41%
Corecare	$465 - $2,552	49%
Texas True Choice	$499 - $2,734	53%
Unicare	$532 - $2,916	56%
Galaxy Health Network	$599 - $3,281	63%
Multiplan	$599 - $3,281	63%
Usa Health Network	$599 - $3,281	63%
Usc Health Services	$599 - $3,281	63%
Aetna	$658 - $3,609	69%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,509.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 45378.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ward Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 45378.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.