CMS Price Transparency Data
Colonoscopy (diagnostic)
Facility: Children's Hosp of Los Angeles
Billing Code: 45378 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 45378
- Insurance Median: $868
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Children's Hosp of Los Angeles is $868. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.91x the Medicare baseline. Located in 4650 Sunset Blvd, Ms 108, Los Angeles, CA.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$868
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%)
Insurance Median: $868 (91%)
Ins. Median: $868 (91% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Caloptima | $413 | 43% |
| Altamed | $413 - $14,725 | 43% |
| Valley Presbyterian Hospital | $423 | 45% |
| Medi-Cal | $423 | 45% |
| Choc Health Alliance | $529 | 56% |
| Health Net | $529 | 56% |
| St Francis Medical Center | $551 - $817 | 58% |
| Watts Healthcare Mmc | $618 | 65% |
| Premier Physicians Ntwk | $618 | 65% |
| Bella Vista Med Grp | $618 | 65% |
| El Proyecto Del Barrio | $618 | 65% |
| Health Care La IPA | $618 | 65% |
| Global Care Medical Group | $618 | 65% |
| Centinela Valley IPA | $618 | 65% |
| Hollywood Presbyterian Medical Center | $635 | 67% |
| Community Family Care IPA | $635 | 67% |
| Heritage Provider Network | $678 - $17,135 | 71% |
| Blue Cross Blue Shield | $698 - $2,416 | 73% |
| La Care | $703 - $14,993 | 74% |
| Serra Community Med Clinic | $726 | 76% |
| White Memorial Medical Center | $741 | 78% |
| Care 1St | $741 | 78% |
| Adventist Health Physicians | $762 - $16,064 | 80% |
| Cal Care IPA | $771 | 81% |
| Hispanic Physician IPA | $783 | 82% |
| Associated Hispanic Physicians IPA | $783 | 82% |
| Serendib Healthways Mmc | $783 | 82% |
| Gold Coast Health Plan | $783 | 82% |
| Beverly Hospital | $788 | 83% |
| San Judas Med Grp | $792 | 83% |
| Los Angeles Medical Center IPA | $792 | 83% |
| Alhambra Hospital Medical Center | $796 | 84% |
| Accountable Health | $809 | 85% |
| Souther California Hosp System - Mmc | $812 | 85% |
| Cencal Health | $817 | 86% |
| Pacific Alliance Medical Center | $830 | 87% |
| Blue Shield | $838 - $4,242 | 88% |
| Point Comfort Underwriters | $847 | 89% |
| Employee Health Systems Med Grp | $847 | 89% |
| Seaside Health Plan | $847 | 89% |
| Angeles IPA | $847 | 89% |
| Crown City Medical Group | $847 | 89% |
| Imperial Health Holdings Medical Group | $864 | 91% |
| Karing Physicians Medical Group | $864 | 91% |
| Regent Medical Group | $864 | 91% |
| Noble Community Medical Associates | $864 | 91% |
| Preferred IPA | $868 | 91% |
| Mabuhay Medical Group | $868 | 91% |
| Exceptional Care Medical Group | $868 - $20,437 | 91% |
| Avalon IPA | $868 | 91% |
| Primary Care and Pediatric IPA | $868 | 91% |
| Inland Empire Health Plan | $872 | 92% |
| Molina | $894 | 94% |
| Family Care Specialists | $894 | 94% |
| Family Health Alliance Med Grp | $910 | 96% |
| Community Care IPA Mmc | $936 | 99% |
| Applecare Medical Group | $936 - $17,403 | 99% |
| Dignity Health | $940 | 99% |
| Allied Pacific IPA | $995 | 105% |
| California Pacific Physicians Medical Group | $1,008 | 106% |
| Healthy New Life Medical Corp | $1,008 | 106% |
| Asian Community Medical Group | $1,008 | 106% |
| Kern Family Health Plan | $1,067 | 112% |
| Superior Choice Medical Group | $1,148 | 121% |
| Southland San Gabriel Valley Medical Group | $1,156 | 122% |
| Cigna | $3,495 | 368% |
| Champus | $4,728 | 498% |
| UnitedHealthcare | $6,367 - $11,700 | 670% |
| Medicare (plans) | $8,751 | 921% |
| Accarent Health | $8,925 | 939% |
| Sierra Health and Life Insurance Company | $10,000 | 1053% |
| Delta Health Systems | $11,564 | 1217% |
| Incentive Health Network | $16,510 | 1738% |
| Gemcare IPA | $17,135 | 1803% |
| Managed Care Systems | $17,403 | 1832% |
| Providence Health Network | $17,849 | 1879% |
| Ventura County Health Plan | $22,758 | 2395% |
| Good Samaritan Medical Group | $24,542 | 2583% |
| Access Medical Group | $24,810 | 2611% |
| Staywell Insurance | $25,000 | 2631% |
| Seoul Medical Group | $27,398 | 2884% |
| Southern Atlantic Medical Group Mmc | $30,531 | 3213% |