CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: PAM Rehabilitation Hospital of Corpus Christi

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,072
Cash Discount Price: $3,926
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at PAM Rehabilitation Hospital of Corpus Christi is $1,072. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,926. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.13x the Medicare baseline. Located in 345 S Water St, Corpus Christi, TX.

Cash / Self-Pay

$3,926

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,072

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: $3,926 (413%)

Insurance Median: $1,072 (113%)

Cash: $3,926 (413% of Medicare)

Ins. Median: $1,072 (113% 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
Aetna	$169 - $858	18%
Driscoll Health Plan	$328	35%
Superior Health	$328	35%
Curative	$643	68%
Ambetter / Centene	$858	90%
Blue Cross Blue Shield	$858 - $926	90%
Christus Health Plan	$858	90%
Christus Spohn Health Network	$858 - $2,356	90%
Cigna	$858	90%
Ilumed Aco Reach	$858	90%
Imperial Insurance Of Texas	$858	90%
UnitedHealthcare	$858	90%
Wellcare Complete	$858	90%
Wellmed	$858	90%
Wellpoint (Amerigroup)	$858	90%
Texas Independence Health Plan	$901	95%
Velocity Provider Ppo Network	$1,029 - $2,945	108%
Prime Health Services	$1,115 - $3,337	117%
Ninety Degree Benefits	$1,287	135%
Sana Benefits	$1,287	135%
Healthcare Highways	$2,159	227%
America'S Choice Provider Network	$2,748	289%
Provider Network Of America	$2,945	310%
Quik Trip	$2,945	310%
Usa Managed Care Organization	$2,945	310%
Multiplan/Phcs	$3,141	331%

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 $3,926.
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 PAM Rehabilitation Hospital of Corpus Christi 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.