CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Camc Greenbrier Valley Medical Center, Inc

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $248
Cash Discount Price: $2,553
vs. Medicare Baseline: 0.26x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Camc Greenbrier Valley Medical Center, Inc is $248. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,553. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.26x the Medicare baseline. Located in 1320 Maplewood Avenue, Ronceverte, WV.

Cash / Self-Pay

$2,553

Average discount available for prompt cash payment at this facility.

Insurance Median

$248

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: $2,553 (269%)

Insurance Median: $248 (26%)

Cash: $2,553 (269% of Medicare)

Ins. Median: $248 (26% 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
Sentra Health	$114 - $1,588	12%
Aetna	$124 - $4,445	13%
Blue Cross Blue Shield	$124 - $4,196	13%
Caresource	$124 - $3,629	13%
The Health Plan	$124 - $4,082	13%
Unicare	$124 - $144	13%
Humana	$132 - $4,082	14%
Multiplan	$132 - $3,946	14%
UnitedHealthcare	$132 - $3,629	14%
Clear Spring Health	$136 - $939	14%
Ally Align	$138 - $957	15%
Integrated Medical Solutions	$184 - $1,732	19%
Naphcare	$263 - $1,823	28%
Greenbrier Resort	$399 - $2,722	42%
Healthsmart	$456 - $2,722	48%
Fedmed	$513 - $4,082	54%

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 $2,553.
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 Camc Greenbrier Valley Medical Center, Inc 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.