CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Arbor Health Morton Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $200
Cash Discount Price: $755
vs. Medicare Baseline: 0.21x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Arbor Health Morton Hospital is $200. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $755. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.21x the Medicare baseline. Located in 521 Adams Street, Morton, WA.

Cash / Self-Pay

$755

Average discount available for prompt cash payment at this facility.

Insurance Median

$200

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: $755 (79%)

Insurance Median: $200 (21%)

Cash: $755 (79% of Medicare)

Ins. Median: $200 (21% 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	$165 - $503	17%
Amerigroup Mcr Adv	$165	17%
Comm Health Mcr Adv	$165	17%
Healthnet Mcr Adv - All Plans	$165	17%
Humana	$165	17%
Mcr Railroad Mcr Adv - All Plans	$165	17%
Medicare (plans)	$165	17%
Premera Hmo Mcr Adv	$165	17%
Rural Health Mcare - All Plans	$165	17%
UnitedHealthcare	$165 - $974	17%
Regence Blue Shield Mcr Adv	$167	18%
Molina Mcr Adv	$173	18%
Wellcare Mcr Adv - All Plans	$173	18%
Amerigroup-All Other Plans	$200	21%
Comm Health Healthy Options	$200	21%
Kaiser Mcaid	$200	21%
Molina Mcaid	$200	21%
Comm Health Basic Sub - All Other Plans	$240	25%
First Choice-All Plans	$254	27%
Kaiser Comm-All Other Plans	$257	27%
Comm Health Pebb	$360	38%
Molina Marketplace-All Other Plans	$731	77%
Regence Blue Shield Ump-All Other Plans	$853	90%
Premera First-All Other Plans	$1,096	115%
Cigna	$1,133	119%

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 $755.
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 Arbor Health Morton 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.