Colonoscopy with biopsy
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $1,086
- Cash Discount Price: $794
- vs. Medicare Baseline: 0.89x 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 $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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $1,086 | 89% |
| Web Tpa [2115] | $1,086 | 89% |
| Healthcare Highways [2210] | $1,086 | 89% |
| Blue Cross Blue Shield | $1,086 | 89% |
| Lucent Health [6000] | $1,086 | 89% |
| Oncology Patient Assistance Programs [2295] | $1,086 | 89% |
| Black Lung [6055] | $1,086 | 89% |
| Hooray Health [8000] | $1,086 | 89% |
| Department Of Corrections [1340] | $1,324 | 108% |
| National Association Of Letter Carriers [1695] | $1,531 | 125% |
| American Postal Workers Union [1070] | $1,531 | 125% |
| Cigna | $1,531 | 125% |
| Healthpartners [1500] | $1,531 | 125% |
| Humana | $1,562 | 128% |
| Multiplan [1680] | $2,058 | 168% |
| First Health [1375] | $2,058 | 168% |
| Administrative Concepts [1005] | $2,058 | 168% |
| American Healthcare [1055] | $2,058 | 168% |
| Coventry Healthcare [1320] | $2,171 | 178% |
| Ks Disability Determination [6090] | $2,648 | 217% |
Consumer Guidance & Cost Commentary
For a colonoscopy with biopsy at the University of Kansas Health System - St Francis Campus in Topeka, the facility's cash price of $794.00 is significantly lower than the gross charge of $2,648.00 and the median negotiated rate of $1,086.00 paid by major payers like Aetna and Cigna. While the facility's cash rate is notably lower than the state average, patients with high-deductible plans may find paying the cash price upfront more cost-effective than relying on insurance, which often results in higher out-of-pocket costs due to deductibles and co-pays. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final amount owed.
The facility's negotiated rates are also lower than the Medicare benchmark of $1,222.56, indicating a pricing structure that aligns with fair market value rather than the inflated chargemaster list. However, because the facility is a voluntary non-profit church-owned hospital, patients should be aware that while the facility itself adheres to these negotiated caps, unexpected balance billing could still occur if ancillary services like emergency physicians or specific lab tests are provided by out-of-network providers. To avoid surprise costs, patients should request a full itemized bill before paying and dispute any charges that do not match the detailed CPT codes for the procedure performed, ensuring that no unbundled items or services not rendered are included in the final invoice.