CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Olympic Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $979
Cash Discount Price: $1,530
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Olympic Medical Center is $979. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,530. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.03x the Medicare baseline. Located in 939 Caroline St, Port Angeles, WA.

Cash / Self-Pay

$1,530

Average discount available for prompt cash payment at this facility.

Insurance Median

$979

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: $1,530 (161%)

Insurance Median: $979 (103%)

Cash: $1,530 (161% of Medicare)

Ins. Median: $979 (103% 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 Uniform	$296 - $1,841	31%
Community Health Plan Of Washington	$424 - $2,635	45%
Ambetter / Centene	$477 - $3,129	50%
Cigna	$516 - $3,208	54%
Aetna	$530 - $3,294	56%
First Choice Network	$530 - $3,294	56%
Gmr/Caldera Care	$530 - $3,294	56%
Hma	$530 - $3,294	56%
Lifewise	$530 - $3,294	56%
Premera	$530 - $3,294	56%
Regence	$530 - $3,294	56%
UnitedHealthcare	$530 - $3,294	56%
Coordinated Care	$914	96%
Molina	$914 - $1,176	96%
Wellpoint (Formerly Amerigroup)	$958	101%
Wellcare	$979	103%

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 $1,530.
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 Olympic 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.