CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Providence Regional Medical Center Everett

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,921
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.02x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Providence Regional Medical Center Everett is $1,921. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 2.02x the Medicare baseline. Located in 1321 Colby Avenue, Everett, WA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,921

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%)
Insurance Median: $1,921 (202%)
Ins. Median: $1,921 (202% 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 202% of the Medicare baseline (a markup of 102%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Kaiser $1,059 - $1,589 111%
Aetna $1,091 - $8,846 115%
UnitedHealthcare $1,112 - $3,284 117%
Blue Shield $1,144 120%
Amerigroup $1,165 123%
Community Health Plan $1,694 178%
Blue Cross Blue Shield $1,906 - $2,311 201%
Coordinated Care $1,959 206%
Providence Health Plan $2,457 259%
First Choice $2,979 314%
Cigna $8,002 842%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1321 Colby Avenue, Everett, WA 98201
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals