CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Bellin Memorial Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,958
Cash Discount Price: $1,362
vs. Medicare Baseline: 2.06x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Bellin Memorial Hospital is $1,958. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,362. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 2.06x the Medicare baseline. Located in 744 S Webster Ave, Green Bay, WI.

Cash / Self-Pay

$1,362

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,958

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: $1,362 (143%)

Insurance Median: $1,958 (206%)

Cash: $1,362 (143% of Medicare)

Ins. Median: $1,958 (206% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 206% of the Medicare baseline (a markup of 106%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Common Ground	$424 - $2,090	45%
Chorus Community Health Plan	$454 - $2,240	48%
Aspirus Arise	$487 - $2,512	51%
UnitedHealthcare	$494 - $2,435	52%
Cigna	$498 - $2,484	52%
Wps Insurance	$515 - $2,961	54%
Hps/Paymedix	$523 - $2,787	55%
Trilogy	$537 - $2,648	57%
Healthsmart	$565 - $2,787	59%
Ihs(Claimsbridge)	$565 - $2,787	59%
Medical College Of Wi	$565 - $2,787	59%
Allied National	$600 - $2,961	63%
First Health	$600 - $2,961	63%
Galaxy Health	$600 - $2,961	63%
Blue Cross Blue Shield	$630 - $2,621	66%
Three Rivers Provider Network	$636 - $3,136	67%
Aetna	$835 - $899	88%
Community Care	$835 - $1,958	88%
Humana	$835 - $1,958	88%
My Choice	$835 - $899	88%
Network Health	$866 - $4,830	91%
Multiplan	$2,787	293%

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 $1,362.
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 Bellin Memorial 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.