What does Bcbsmt pay for CPT 45378 in Iowa City, IA?

The local peer median for CPT 45378 under Bcbsmt in Iowa City, IA is $928.20, based on 482 indexed providers. Modeled from published rates, not guaranteed.

What is the top of the local market (P90) for CPT 45378 under Bcbsmt in Iowa City, IA?

The P90, the top of the local market and Reddenda's target rate, is $928.20.

How does Bcbsmt's rate for CPT 45378 compare to Medicare?

The Bcbsmt local median of $928.20 is 245% of Medicare's national non-facility rate of $378.10 for CPT 45378.

Reddenda · Rate Intelligence · Iowa City, IA

45378 under Bcbsmt in Iowa City, IA

Name: Bcbsmt rates for CPT 45378 in Iowa City, IA
Creator: Reddenda

Diagnostic colonoscopy · Local peer median $928.20 · Medium confidence

$928.20 local peer median. In the Iowa City, IA market, Bcbsmt pays a local peer median of $928.20 for CPT 45378 (Diagnostic colonoscopy), based on 482 providers in Reddenda's index of Bcbsmt's own published in-network rates. The top of the local market, the P90 target, is $928.20, which is the same as the median here: this payer's filed rates for this code cluster on one number, so the opportunity in this cell is reaching the median rather than exceeding it. A provider billed below the local median is being paid less than peers holding the identical Bcbsmt contract in Iowa City, IA for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 482 providers · 483 rate records

P10

$742.60

P25

$789

Median

$928.20

P75

$928.20

P90 (target)

$928.20

P10$742.60

P25$789

Median (P50)$928.20

P75$928.20

P90 target$928.20

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $220.23 – $1,368

The local peer median for CPT 45378 under Bcbsmt in Iowa City, IA is $928.20, drawn from 482 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsmt to publish this rate
The bottom of the local market (P10) is $742.60 and the top (P90) is $928.20; the median-to-P90 spread is $0.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsmt to publish this rate
The lowest published rate in this market is $220.23; the highest is $1,368.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsmt to publish this rate
This benchmark is drawn from 483 individual rate records that Bcbsmt itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsmt to publish this rate
Medicare's national non-facility rate for CPT 45378 is $378.10, making the Bcbsmt local median 245% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsmt to publish this rate
51.3% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsmt to publish this rate
A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute over this exact code and payer.Source: 45 CFR §149.510(c)(4)(iii)(B)

482 providers bill this code to this payer in this metro.

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This is the local market for CPT 45378 (Diagnostic colonoscopy) under Bcbsmt in Iowa City, IA. Enter your NPI to see your own contracted rate against this peer curve, per payer and per code. Free, about 15 seconds, no card and no PHI.

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Documented reimbursement opportunity, modeled from published rates and never a guaranteed outcome.

Modeled from Bcbsmt's own published in-network rates, never guaranteed and never a national average. Peer basis: same CPT, same payer file, same metro (CBSA). Federal citation for the underlying obligation: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsmt to publish this rate. Page generated 2026-08-24 01:54 UTC; the live index is queried in real time on every request.