CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Lake Chelan Community Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,857
Cash Discount Price: $2,855
vs. Medicare Baseline: 1.95x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Lake Chelan Community Hospital is $1,857. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,855. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.95x the Medicare baseline. Located in 110 S Apple Blossom Dr, Chelan, WA.

Cash / Self-Pay

$2,855

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,857

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: $2,855 (300%)

Insurance Median: $1,857 (195%)

Cash: $2,855 (300% of Medicare)

Ins. Median: $1,857 (195% 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
Amerigroup Op Only - All Plans	$105 - $2,497	11%
UnitedHealthcare	$105 - $3,974	11%
Medicare (plans)	$165 - $2,351	17%
Molina - All Plans	$165 - $3,949	17%
Coordinated Care Mcaid	$200 - $2,497	21%
Coordinated Care Comm - All Other Plans	$215 - $4,195	23%
Premera First - All Plans	$245 - $3,205	26%
First Choice - All Plans	$257 - $4,060	27%
Aetna	$1,292 - $3,846	136%
Corvel - All Plans	$1,364 - $4,060	144%
Multiplan - All Plans	$3,804	400%

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 $2,855.
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 Lake Chelan Community 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.