Colonoscopy (diagnostic)
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $831
- Cash Discount Price: $608
- vs. Medicare Baseline: 0.87x 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 |
|---|---|---|
| Web Tpa [2115] | $831 | 87% |
| Oncology Patient Assistance Programs [2295] | $831 | 87% |
| Black Lung [6055] | $831 | 87% |
| Blue Cross Blue Shield | $831 | 87% |
| Hooray Health [8000] | $831 | 87% |
| Aetna | $831 | 87% |
| Healthcare Highways [2210] | $831 | 87% |
| Lucent Health [6000] | $831 | 87% |
| Department Of Corrections [1340] | $1,014 | 107% |
| Healthpartners [1500] | $1,172 | 123% |
| National Association Of Letter Carriers [1695] | $1,172 | 123% |
| American Postal Workers Union [1070] | $1,172 | 123% |
| Cigna | $1,172 | 123% |
| Humana | $1,197 | 126% |
| Administrative Concepts [1005] | $1,576 | 166% |
| American Healthcare [1055] | $1,576 | 166% |
| Multiplan [1680] | $1,576 | 166% |
| First Health [1375] | $1,576 | 166% |
| Coventry Healthcare [1320] | $1,663 | 175% |
| Ks Disability Determination [6090] | $2,028 | 213% |
Consumer Guidance & Cost Commentary
For the diagnostic colonoscopy procedure at the University Of Kansas Health System - St Francis Campus, the facility's cash median rate of $608.00 is significantly lower than the state average, which sits at $950.10 based on Medicare benchmarking. While the gross charge listed is $2,028.00, commercial insurance negotiated rates average $831.00, which remains higher than the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $608.00 rate avoids the multi-layered administrative costs and potential deductibles associated with insurance claims. It is important to verify this cash rate with the hospital before scheduling, as self-pay or prompt-pay discounts can further reduce the final amount owed.
The facility's pricing reflects a voluntary non-profit church ownership model, with 20 different payers negotiating rates ranging from $831.00 to $2,028.00 depending on the specific plan and payer tier. Although the median negotiated rate across payers is $831.00, individual contracts vary widely, with some plans paying up to the full gross amount. To ensure you are not overpaying, request a detailed itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, if you choose to use insurance, be aware that balance billing protections under the No Surprises Act may apply if you receive care from out-of-network providers at this in-network facility, preventing unexpected charges for emergency or non-emergency services