CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Texas Health Presbyterian Hospital Flower Mound

Billing Code: 45378 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,042

about 1.1× the $950 Medicare rate · typically $960–$1,690

modeled estimate · not a bill or quote

What this hospital charges insurers

$976

About the fair price

about $66 under the fair price · 1.0× Medicare

Medicare pays $950 Fair price $1,042 This hospital $976 Cash price $1,899 Hospital's list price $3,165

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

Highest price of the 9 TX hospitals we have prices for — worth calling around.

Cheapest $100 Priciest $976

Black dot = this hospital, among the 9 TX hospitals with a price for this procedure. Full list below.

A fair price for a Colonoscopy (diagnostic) is about $1,042 (about 1.1× the $950 Medicare rate). Texas Health Presbyterian Hospital Flower Mound charges insurers about $976, or about $1,899 in cash — about the fair price. Located in Flower Mound, TX.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$328 - $3,751	35%
Blue Cross Blue Shieldmajor	$328 - $6,383	35%
Aetnamajor	$361 - $2,219	38%
Cignamajor	$1,750 - $2,978	184%
Humanamajor	$972	102%
Amerigroup	$328 - $981	35%
Cigna HealthSpring	$953	100%
Molina	$355 - $981	37%
WellCare	$345 - $1,028	36%
+ 6 smaller / regional plans	$328 - $2,785

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,899), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 45378.

Insurance Before you use insurance

Call your insurance company to confirm Texas Health Presbyterian Hospital Flower Mound is in-network.
Ask your insurer whether prior approval is required for CPT code 45378.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Texas Health Presbyterian Hospital Flower Mound

Compare: Colonoscopy (diagnostic) at other TX hospitals

Insurance negotiated median for the same procedure, sorted lowest first.