CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Trios Health

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,452
Cash Discount Price: $993
vs. Medicare Baseline: 1.53x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Trios Health is $1,452. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $993. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.53x the Medicare baseline. Located in 3780 Plaza Way, Kennewick, WA.

Cash / Self-Pay

$993

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,452

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: $993 (105%)

Insurance Median: $1,452 (153%)

Cash: $993 (105% of Medicare)

Ins. Median: $1,452 (153% 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
Regence Group Administrators	$289	30%
UnitedHealthcare	$486 - $2,482	51%
Community Health Plan Of Washington	$646	68%
Molina Healthcare Of Washington	$646 - $1,556	68%
Coordinated Care Of Washington Inc	$665	70%
Wellpoint Washington, Inc.	$678	71%
Ods Community Health Inc	$759	80%
Veteran Family Member Program	$932	98%
Humana	$979	103%
Aetna	$1,449 - $1,455	153%
Cigna	$1,653	174%
Asuris Northwest Health	$2,035	214%
Ods Health Plan Inc	$2,109	222%
Blue Cross Blue Shield	$2,402	253%
Lifewise Health Plan Of Wa	$2,402	253%
Government Employees Health Association	$2,482	261%

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 $993.
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 Trios Health 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.