CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Lincoln Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $165
Cash Discount Price: $800
vs. Medicare Baseline: 0.17x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Lincoln Hospital is $165. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $800. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.17x the Medicare baseline. Located in 10 Nichols Street, Davenport, WA.

Cash / Self-Pay

$800

Average discount available for prompt cash payment at this facility.

Insurance Median

$165

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: $800 (84%)

Insurance Median: $165 (17%)

Cash: $800 (84% of Medicare)

Ins. Median: $165 (17% 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
Ambetter / Centene	$105	11%
Molina Hlthy Options	$105 - $200	11%
Amerigroup Mcaid - All Plans	$111	12%
Tricare	$149	16%
Aetna	$165	17%
Asuris Nw Health-All Plans	$165	17%
Indian Hlth Services - All Plans	$165	17%
UnitedHealthcare	$165 - $200	17%
Va Ccn - All Plans	$165	17%
First Choice Health- All Plans	$254	27%
Molina Exchange-All Other Plans	$264	28%
Labor & Industries - All Plans	$325	34%
First Health Coventry-All Plans	$791 - $792	83%

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 $800.
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 Lincoln Hospital 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.