CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Comanche County Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $923
Cash Discount Price: $1,300
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Comanche County Medical Center is $923. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,300. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.97x the Medicare baseline. Located in 10201 Hwy 16, Comanche, TX.

Cash / Self-Pay

$1,300

Average discount available for prompt cash payment at this facility.

Insurance Median

$923

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: $1,300 (137%)

Insurance Median: $923 (97%)

Cash: $1,300 (137% of Medicare)

Ins. Median: $923 (97% 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
Choicecare Comm - All Other Plans	$161 - $1,266	17%
Choicecare Mcr Adv	$161 - $1,266	17%
Humana	$161 - $2,395	17%
Molina Mcr Adv - All Other Plans	$161 - $1,266	17%
Pphp Mcr Adv - All Plans	$161 - $1,266	17%
Superior Epo/Hmo - All Plans	$161 - $1,266	17%
Swhp Comm - All Other Plans	$161 - $2,738	17%
Swhp Mcr Adv	$161 - $1,266	17%
Wellmed Mcr Adv - All Plans	$161 - $1,266	17%
Aetna	$178 - $2,156	19%
First Care Hmo - All Other Plans	$178 - $2,909	19%
First Care Hmo Self Funded	$178 - $2,909	19%
Occunet - All Plans	$209 - $2,566	22%
Alliance Wc - All Plans	$242 - $1,899	25%
Cigna	$376 - $2,224	40%
Blue Cross Blue Shield	$511 - $2,566	54%
Molina Mcaid	$579 - $2,156	61%
Swhp Mcaid	$579 - $2,156	61%
Mpi - All Plans	$3,080	324%

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 $1,300.
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 Comanche County Medical Center 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.