CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Kosciusko Community Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $584
  • Cash Discount Price: $257
  • vs. Medicare Baseline: 0.48x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Kosciusko Community Hospital is $584. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $257. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.48x the Medicare baseline. Located in 2101 E Dubois Dr, Warsaw, IN.
Cash / Self-Pay
$257

Average discount available for prompt cash payment at this facility.

Insurance Median
$584

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$1,222.56

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $1,222.56 (100%)
Cash / Self-Pay: $257 (21%)
Insurance Median: $584 (48%)
Cash: $257 (21% of Medicare)
Ins. Median: $584 (48% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $1,222.56 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
Amish Aid $132 - $2,672 11%
Self Pay $132 - $2,672 11%
One Call Care Diagnostics Wc $167 14%
Lutheran Preferred Network $199 - $10,179 16%
Physicians Health Plan $232 - $5,863 19%
Php Freedom Network $243 - $4,914 20%
UnitedHealthcare $245 - $6,693 20%
Encore $252 - $5,090 21%
Trma Inc $252 - $1,121 21%
Aetna $258 - $6,769 21%
Connecticut General Life Insurance Company $370 - $7,494 30%
Veterans Eval Services $385 31%
Cigna $398 - $8,042 33%
First Health Network $472 - $9,543 39%
Prime Health Services $472 - $9,543 39%
Advantage Health $522 - $10,561 43%
Private Healthcare Systems $541 - $10,943 44%
Sagamore $554 - $11,960 45%
Encore Health Network $585 - $11,833 48%
Tricare $1,203 98%
Department Of Veterans Affairs $1,266 104%
Blue Cross Blue Shield $1,334 - $5,203 109%
Humana $1,334 - $3,122 109%
Medicare (plans) $1,334 109%
Mhs $1,334 - $3,122 109%
Iu Health $1,356 111%
Node Non Par Hospice Agree $1,356 111%
Node Va $1,356 111%
Node Devoted Health Mcr Adv $1,361 111%
In Dept Of Correction $1,410 115%
Node Pphp Mcr Adv $1,424 116%
Us Department Of Labor $1,695 139%
Lutheran Advanced Network $2,034 166%
Lutheran Preferred $2,034 - $2,712 166%
Align In Work Comp $2,170 177%
One Call Work Comp $2,170 177%
Caresource $2,401 - $3,122 196%
Encore Work Comp In $2,441 200%
Managed Health Services Exchange $2,712 222%
Workers Comp $2,712 222%
Managed Health Services $3,122 255%
Medicaid / KanCare $3,122 255%
Encore Kba Epo $3,254 266%
Encore Kba Ppo $4,068 333%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2101 E Dubois Dr, Warsaw, IN 46580
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals