CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Uva Health Culpeper Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,814
Cash Discount Price: $1,680
vs. Medicare Baseline: 1.91x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Uva Health Culpeper Medical Center is $1,814. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,680. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.91x the Medicare baseline. Located in 501 Sunset Lane, Culpeper, VA.

Cash / Self-Pay

$1,680

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,814

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: $1,680 (177%)

Insurance Median: $1,814 (191%)

Cash: $1,680 (177% of Medicare)

Ins. Median: $1,814 (191% 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
Champva [50002]	$180 - $184	19%
Tricare	$180 - $184	19%
Blue Ridge Pace [10510]	$840	88%
Medicaid / KanCare	$840	88%
Aetna	$933 - $1,814	98%
Blue Cross Blue Shield	$933 - $2,786	98%
Cigna	$933 - $6,128	98%
HMO Part B [10099]	$933	98%
Humana	$933 - $981	98%
Medicare (plans)	$933 - $962	98%
UnitedHealthcare	$933 - $5,807	98%
VA Ccn [99926]	$933 - $962	98%
VA Ccn [99927]	$933 - $962	98%
Veterans Administration [99910]	$962	101%
Beacon Health Options [40012]	$1,514	159%
Commercial Contracted Hb Only [40056]	$1,589	167%
Commercial Generic [40000]	$1,589 - $2,119	167%
Commercial Contracted Tpa [40055]	$1,816 - $2,119	191%
Geha [40009]	$1,911 - $4,651	201%
Umwa [40037]	$2,119	223%
Healthsmart [40013]	$2,270	239%
Multiplan Generic [40035]	$2,301 - $2,573	242%
Vhn Generic [40040]	$2,301 - $2,573	242%
First Health Generic [40033]	$2,482	261%
Gateway Health Alliance [40034]	$2,573	271%
Onenet Workers Comp Generic [60010]	$2,652	279%
Kaiser Permenente [40014]	$2,724 - $3,023	287%
Carefirst [30007]	$3,044 - $3,448	320%

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 $1,680.
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 Uva Health Culpeper Medical Center 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.