CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Cascade Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $486
Cash Discount Price: $1,243
vs. Medicare Baseline: 0.51x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Cascade Medical Center is $486. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,243. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.51x the Medicare baseline. Located in 817 Commercial Street, Leavenworth, WA.

Cash / Self-Pay

$1,243

Average discount available for prompt cash payment at this facility.

Insurance Median

$486

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: $1,243 (131%)

Insurance Median: $486 (51%)

Cash: $1,243 (131% of Medicare)

Ins. Median: $486 (51% 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
Aetna	$186 - $2,311	20%
Asuris Northwest Health	$186 - $2,311	20%
Blue Cross Blue Shield	$186 - $1,952	20%
Humana	$186 - $1,485	20%
Medicare (plans)	$186 - $1,485	20%
Molina Healthcare Of Washington Mcr Adv	$188 - $1,500	20%
Wellcare Health Plan Inc Mcr Adv	$201 - $1,604	21%
Medicaid / KanCare	$288 - $1,372	30%
Community Health Plan Of Wa Mcd Rep	$300 - $1,429	32%
Coordinated Care Of Wa Mcd Rep	$300 - $1,429	32%
Molina Healthcare Of Washington Mcd Rep	$300 - $1,429	32%
Ambetter / Centene	$339 - $1,610	36%
Tricare	$346	36%
Community Health Plan Of Wa	$351 - $1,669	37%
First Choice Health Network	$436	46%
Pacificsource Health Plans	$436	46%
Cigna	$451 - $2,147	47%
Washington Department Of Labor And Industry	$482 - $2,291	51%

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 $1,243.
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 Cascade 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.