CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: St Luke's Patients Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,370
  • Cash Discount Price: $1,376
  • vs. Medicare Baseline: 1.44x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at St Luke's Patients Medical Center is $1,370. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,376. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.44x the Medicare baseline. Located in 4600 East Sam Houston Parkway South, Pasadena, TX.
Cash / Self-Pay
$1,376

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,370

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: $1,376 (145%)
Insurance Median: $1,370 (144%)
Cash: $1,376 (145% of Medicare)
Ins. Median: $1,370 (144% 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
Chc $312 33%
Tchp $312 33%
Wellpoint $328 - $1,370 35%
United $335 - $3,778 35%
Blue Cross Blue Shield $573 - $1,467 60%
Cigna $913 - $7,221 96%
Humana $913 - $1,782 96%
Kelsey $913 96%
Aetna $931 - $2,988 98%
Amerivantage $941 99%
Devoted $977 103%
Scanhealth $977 103%
Bright Health $1,327 140%
Ambetter / Centene $1,370 144%
Community Health Choice $1,370 144%
Coventry $2,555 269%
First Health $2,555 269%
Healthsmart $2,752 290%
Multiplan $2,948 310%
PHCS $5,185 546%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4600 East Sam Houston Parkway South, Pasadena, TX 77505
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals