CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Primary Children's Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,698
  • Cash Discount Price: $1,794
  • vs. Medicare Baseline: 1.79x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Primary Children's Hospital is $1,698. 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 1.79x the Medicare baseline. Located in 100 North Mario Capecchi Drive, Salt Lake City, UT.
Cash / Self-Pay
$1,794

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,698

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: $1,698 (179%)
Cash: $1,794 (189% of Medicare)
Ins. Median: $1,698 (179% 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.

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
American Health $163 - $1,363 17%
Health Plan Of Nevada $163 - $444 17%
Healthy U $163 - $545 17%
Molina $163 - $2,009 17%
Selecthealth $163 - $2,009 17%
Southwest Behavioral Health $163 - $832 17%
UnitedHealthcare $163 - $2,009 17%
Donor Connect $861 - $952 91%
Tricare $874 92%
Triwest $874 92%
Aetna $1,698 - $2,033 179%
Awh Connected $1,698 - $2,033 179%
Byu Athletics $1,698 - $2,009 179%
Campbell Scientific $1,698 - $2,009 179%
Cigna $1,698 - $2,009 179%
Deseret Mutual $1,698 - $2,009 179%
Emi $1,698 - $2,009 179%
Emi Health $1,698 - $2,009 179%
First Choice $1,698 - $2,009 179%
First Choice Of The Midwest $1,698 - $2,009 179%
Franklin County $1,698 - $2,009 179%
Global Excel $1,698 - $2,009 179%
Health Utah $1,698 - $2,009 179%
Humana $1,698 - $2,009 179%
Hygeia Corporation $1,698 - $2,009 179%
Ifit $1,698 - $2,009 179%
Juniper Systems $1,698 - $2,009 179%
Lw Miller $1,698 - $2,009 179%
Managed Care Admin $1,698 - $2,009 179%
Medcare International $1,698 - $2,009 179%
Motivhealth $1,698 - $2,009 179%
Pehp $1,698 - $2,009 179%
Prodegi Corp Benefit $1,698 - $2,009 179%
Tanner Llc $1,698 - $2,009 179%
Uofu $1,698 - $2,009 179%
Utah Tech $1,698 - $2,009 179%
Wise Network $1,698 - $2,009 179%
First Health $1,722 - $2,033 181%
Blue Cross Blue Shield $1,746 - $2,057 184%
Springtide $1,746 - $2,057 184%
Utah Behavioral Health Network $1,938 204%
Altius Mhnet Behavioral Health $2,105 222%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 North Mario Capecchi Drive, Salt Lake City, UT 84113
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens