Colonoscopy (diagnostic)
Facility: St. Catherine Hospital - Garden City
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $175
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.18x 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 |
|---|---|---|
| Cigna | $162 - $175 | 17% |
| Kaiser | $162 - $175 | 17% |
| Medicare (plans) | $162 - $175 | 17% |
| Humana | $162 - $175 | 17% |
| Kansas Health | $162 | 17% |
| Blue Cross Blue Shield | $162 - $1,566 | 17% |
| Aetna | $162 - $175 | 17% |
| UnitedHealthcare | $162 - $175 | 17% |
| Innovage | $175 | 18% |
| Devoted Health | $175 | 18% |
Consumer Guidance & Cost Commentary
For a diagnostic colonoscopy at St. Catherine Hospital in Garden City, Kansas, the negotiated rates for in-network insurance plans range from $162 to $175, with a median of $175. This aligns closely with the state average for this procedure, as the data indicates a uniform pricing structure across major payers like Cigna, Kaiser, and Humana. While the facility is a voluntary non-profit church-owned hospital, the lack of a significant variance from the state average suggests standard market pricing rather than inflated markups. It is important to note that while these rates are contractually agreed upon to protect in-network members, they often include administrative costs that can make them higher than cash prices, particularly for patients with high-deductible plans who may benefit from paying directly.
The Medicare benchmark for this service is $950.10, which serves as a critical baseline for evaluating the facility's pricing. Although the commercial negotiated rate of $175 appears lower than the Medicare amount in this specific dataset, patients should be aware that commercial rates typically average 200% to 300% of Medicare in many markets; however, this specific code shows a variance of 0.2, indicating a unique pricing dynamic. To ensure you are receiving the best possible price, we strongly recommend asking the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can bypass insurance billing cycles and reduce costs by 20% to 50%. Additionally, if you have any balance billing concerns, remember that the No Surprises Act protects you from unexpected out-of-network charges for emergency or non-emergency services at in-network facilities.