CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Intermountain Health Sevier Valley Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $2,272
  • Cash Discount Price: $1,794
  • vs. Medicare Baseline: 2.39x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Intermountain Health Sevier Valley Hospital is $2,272. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,794. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 2.39x the Medicare baseline. Located in 1000 North Main Street, Richfield, UT.
Cash / Self-Pay
$1,794

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,272

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: $1,794 (189%)
Insurance Median: $2,272 (239%)
Cash: $1,794 (189% of Medicare)
Ins. Median: $2,272 (239% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 239% of the Medicare baseline (a markup of 139%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $163 - $2,296 17%
American Health $163 - $1,049 17%
Health Partners Of Nevada $163 - $1,008 17%
Health Plan Of Nevada $163 - $2,129 17%
Healthy U $163 - $2,129 17%
Humana $163 - $2,272 17%
Molina $163 - $2,272 17%
Selecthealth $163 - $2,272 17%
UnitedHealthcare $163 - $2,272 17%
Triwest $874 92%
Awh Connected $1,453 - $2,296 153%
Blue Cross Blue Shield $1,453 - $2,272 153%
Byu Athletics $1,453 - $2,272 153%
Campbell Scientific $1,453 - $2,272 153%
Cigna $1,453 - $2,272 153%
Deseret Mutual $1,453 - $2,272 153%
Emi $1,453 - $2,272 153%
Emi Health $1,453 - $2,272 153%
Franklin County $1,453 - $2,272 153%
Health Utah $1,453 - $2,272 153%
Ifit $1,453 - $2,272 153%
Juniper Systems $1,453 - $2,272 153%
Lw Miller $1,453 - $2,272 153%
Managed Care Admin $1,453 - $2,272 153%
Motivhealth $1,453 - $2,272 153%
Pehp $1,453 - $2,272 153%
Prodegi Corp Benefit $1,453 - $2,272 153%
Tanner Llc $1,453 - $2,272 153%
Utah Tech $1,453 - $2,272 153%
Wise Network $1,453 - $2,272 153%
Injury Care Of Nevada $1,794 189%
Byu Risk Management $2,033 214%
Corporation Of The President $2,033 214%
Corvel Corporation $2,033 214%
Wcf Insurance $2,033 214%
Global Excel $2,272 239%
Hygeia Corporation $2,272 239%
Medcare International $2,272 239%
Springtide $2,272 239%
Uofu $2,272 239%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 North Main Street, Richfield, UT 84701
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals