CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Hill Regional Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $9,776
  • Cash Discount Price: $13,965
  • vs. Medicare Baseline: 10.29x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Hill Regional Hospital is $9,776. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,965. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 10.29x the Medicare baseline. Located in 101 Circle Drive, Hillsboro, TX.
Cash / Self-Pay
$13,965

Average discount available for prompt cash payment at this facility.

Insurance Median
$9,776

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: $13,965 (1470%)
Insurance Median: $9,776 (1029%)
Cash: $13,965 (1470% of Medicare)
Ins. Median: $9,776 (1029% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1029% of the Medicare baseline (a markup of 929%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Great-West Healthcare $1,397 147%
The First Health Network $2,095 221%
UnitedHealthcare $7,918 833%
Managed Care $9,776 1029%
Cigna $10,474 1102%
Aetna $11,870 1249%
Usa Managed Care Organization $11,870 1249%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 101 Circle Drive, Hillsboro, TX 76645
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals