CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Holy Cross Hospital-Davis

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $2,151
Cash Discount Price: $1,633
vs. Medicare Baseline: 2.26x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Holy Cross Hospital-Davis is $2,151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,633. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 2.26x the Medicare baseline. Located in 1600 West Antelope Drive, Layton, UT.

Cash / Self-Pay

$1,633

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,151

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: $1,633 (172%)

Insurance Median: $2,151 (226%)

Cash: $1,633 (172% of Medicare)

Ins. Median: $2,151 (226% 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 226% of the Medicare baseline (a markup of 126%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$147	15%
Uuhp	$147 - $2,213	15%
Humana	$169	18%
Medicare (plans)	$169	18%
Employer Direct Healthcare	$212	22%
Motivhealth	$224	24%
Select Health	$354 - $2,006	37%
Molina	$364 - $1,753	38%
Blue Cross Blue Shield	$871 - $2,449	92%
Cigna	$1,181 - $3,266	124%
Centura Employee Plan	$1,267	133%
Pehp	$1,743 - $4,801	183%
Aetna	$1,804 - $3,449	190%
Wise	$2,123 - $2,164	223%
Deseret Mutual Benefit Administrators	$2,506	264%
Multiplan	$2,817 - $3,715	296%
UnitedHealthcare	$2,960 - $4,082	312%
Emi Health	$3,552	374%

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 $1,633.
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 Holy Cross Hospital-Davis 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.