CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Seton Medical Center Harker Heights

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $775
Cash Discount Price: $199
vs. Medicare Baseline: 0.82x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Seton Medical Center Harker Heights is $775. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $199. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.82x the Medicare baseline. Located in 850 W Central Texas Expressway, Harker Heights, TX.

Cash / Self-Pay

$199

Average discount available for prompt cash payment at this facility.

Insurance Median

$775

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: $199 (21%)

Insurance Median: $775 (82%)

Cash: $199 (21% of Medicare)

Ins. Median: $775 (82% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Medicaid / KanCare	$268 - $775	28%
Healthscope Benefits [2290]	$358	38%
UnitedHealthcare	$358 - $775	38%
Aetna	$368 - $1,141	39%
Bell County Indigent Health Svc [3530]	$377	40%
Healthcare Highways [2210]	$775	82%
Oncology Patient Assistance Programs [2295]	$775	82%
Selecthealth [3740]	$775	82%
Web Tpa [2115]	$775 - $1,590	82%
Blue Cross Blue Shield	$1,471	155%
First Care Commercial [1371]	$1,491	157%
Allied Benefit Systems Inc [1030]	$1,590	167%
Cigna	$1,722	181%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $199.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 45378.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Seton Medical Center Harker Heights is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 45378.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.