CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Methodist Hospital Stone Oak

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,176
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Methodist Hospital Stone Oak is $1,176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.24x the Medicare baseline. Located in 1139 E Sonterra Blvd,, San Antonio, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,176

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%)
Insurance Median: $1,176 (124%)
Ins. Median: $1,176 (124% 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
United $328 - $3,917 35%
Usa Managed Care Chip $328 35%
Community First Health Plans $335 - $365 35%
Molina Healthcare $361 38%
Amerigroup $363 38%
Humana $411 43%
Aetna $415 - $2,936 44%
Superior Health $948 100%
Wellcare $962 - $981 101%
Imperial Insurance $1,028 108%
Blue Cross Blue Shield $1,176 - $1,971 124%
Oscar $1,377 145%
First Health $1,836 193%
Fidelis Securecare $2,115 223%
Curative Administrators $2,613 275%
Focus Health Solutions $2,800 295%
Valenz $2,911 306%
Cigna $3,031 - $4,014 319%
Healthcare Highways $3,041 320%
Evry Health $3,571 376%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1139 E Sonterra Blvd,, San Antonio, TX 78258
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals