CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: CHI St Lukes Lakeside Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,005
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at CHI St Lukes Lakeside Hospital is $1,005. 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 1.06x the Medicare baseline. Located in 17400 St Lukes Way, The Woodlands, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,005

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: $1,005 (106%)
Ins. Median: $1,005 (106% 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
Tchp $328 - $440 35%
Wellpoint $328 - $1,370 35%
United $335 - $3,778 35%
UnitedHealthcare $335 - $1,025 35%
Blue Cross Blue Shield $345 - $1,467 36%
Chc $378 - $506 40%
Renaissance $658 69%
Cigna $913 - $7,221 96%
Humana $913 - $1,782 96%
Kelsey $913 96%
Selectcare $913 96%
Aetna $931 - $1,406 98%
Amerivantage $941 99%
Devoted $977 103%
Scanhealth $977 103%
Kindred $1,005 106%
Kelseycare $1,233 - $1,362 130%
Bright Health $1,327 140%
Ambetter / Centene $1,370 144%
Community Health Choice $1,370 144%
Harris Health $1,370 144%
Independent Med System $1,675 176%
Nx Health $2,968 312%
PHCS $5,185 546%
PHCS Savility $5,185 546%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 17400 St Lukes Way, The Woodlands, TX 77384
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals