Colonoscopy (diagnostic)
Facility: Kenmore Mercy Hospital
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $157
- Cash Discount Price: $722
- vs. Medicare Baseline: 0.17x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $52 - $175 | 5% |
| Independent Health Essential [100166] | $52 - $103 | 5% |
| Univera Healthcare [100169] | $75 - $275 | 8% |
| Univera Healthcare Essential [100170] | $75 - $151 | 8% |
| Beacon Essential [350122] | $79 - $210 | 8% |
| Medicare (plans) | $86 - $324 | 9% |
| Hospice [550001] | $87 - $175 | 9% |
| Champ VA [700002] | $87 - $175 | 9% |
| Catholic Health Life Pace [400005] | $87 - $175 | 9% |
| Fallon Health [450115] | $87 - $175 | 9% |
| Covid19 Hrsa [45013] | $87 - $175 | 9% |
| Cigna | $87 - $253 | 9% |
| Tricare | $87 - $175 | 9% |
| Seneca Nation [450119] | $87 - $175 | 9% |
| Wellcare Fidelis Dual [450451] | $92 - $183 | 10% |
| Fidelis Dual Advantage [450120] | $92 - $183 | 10% |
| Aetna | $92 - $183 | 10% |
| Wellcare [450129] | $96 - $192 | 10% |
| Fidelis Essential [100163] | $96 - $192 | 10% |
| Ghi [100153] | $96 - $192 | 10% |
| Crime Victims [100176] | $103 | 11% |
| Excellus Rochester McD [350117] | $103 | 11% |
| Vna Option Mltc [350110] | $103 | 11% |
| Amerigroup [350102] | $103 | 11% |
| Tuscarora Nation [550120] | $103 | 11% |
| Blue Cross Blue Shield | $103 - $315 | 11% |
| Fidelis Exchange [100164] | $105 - $210 | 11% |
| Beacon Health Options [100023] | $105 - $210 | 11% |
| Mvp Healthcare [100168] | $115 - $230 | 12% |
| UnitedHealthcare | $122 - $204 | 13% |
| UPMC Health Plan [100181] | $157 - $314 | 17% |
| VA Veterans Affairs [700001] | $157 | 17% |
| Independent Health [100165] | $160 - $319 | 17% |
| Iha First Choice [800001] | $160 - $319 | 17% |
| Humana | $183 | 19% |
| Molina Essential [100167] | $232 | 24% |
| Federal Workers Compensation [500100] | $709 | 75% |
| No Fault [114001] | $709 | 75% |