CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Beloit Health System

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,202
  • Cash Discount Price: $722
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Beloit Health System is $1,202. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $722. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.27x the Medicare baseline. Located in 1969 W Hart Rd, Beloit, WI.
Cash / Self-Pay
$722

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,202

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: $722 (76%)
Insurance Median: $1,202 (127%)
Cash: $722 (76% of Medicare)
Ins. Median: $1,202 (127% 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.

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 $159 - $2,594 17%
Blue Cross Blue Shield $159 - $3,031 17%
Dean Health $159 - $4,948 17%
Independent Care Health Plan $159 - $979 17%
Quartz $159 - $1,557 17%
UnitedHealthcare $159 - $2,347 17%
Naphcare $239 - $1,468 25%
Cook Children'S Health Plan (Cchp) $359 - $979 38%
Humana $642 - $3,641 68%
The Alliance $678 - $3,915 71%
Wps $717 - $2,023 75%
Managed Health Services $979 103%
Molina Healthcare $979 103%
Wellcare $979 103%
Wea Trust $1,252 - $1,502 132%
Multiplan $1,820 - $2,185 192%
Health Eos $2,071 - $2,485 218%
Cigna $2,162 - $2,594 228%
Hfn $2,162 - $2,594 228%
Preferred Network Access $2,162 - $2,594 228%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1969 W Hart Rd, Beloit, WI 53511
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals