Colonoscopy with biopsy
Facility: St. Catherine Hospital - Garden City
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $190
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.16x 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 |
|---|---|---|
| Blue Cross Blue Shield | $176 - $1,616 | 14% |
| Humana | $176 - $190 | 14% |
| Aetna | $176 - $190 | 14% |
| Kansas Health | $176 | 14% |
| UnitedHealthcare | $176 - $190 | 14% |
| Cigna | $176 - $190 | 14% |
| Medicare (plans) | $176 - $190 | 14% |
| Kaiser | $176 - $190 | 14% |
| Devoted Health | $190 | 16% |
| Innovage | $190 | 16% |
Consumer Guidance & Cost Commentary
For the CPT code 45380, representing a colonoscopy with biopsy at St. Catherine Hospital in Garden City, Kansas, the negotiated rates across ten insurance plans range from $176 to $190. This facility is a voluntary non-profit church-owned acute care hospital located in Garden City, KS (zip 67846). While the data does not provide a specific cash or median paid amount for this service, patients should be aware that cash-pay options can sometimes result in lower out-of-pocket costs if their insurance negotiated rate exceeds the cash price, particularly for those with high-deductible plans. It is highly recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can significantly reduce the final bill by bypassing administrative processing fees and insurance claim cycles.
When evaluating costs, it is important to compare these rates against the Medicare benchmark rather than the hospital's full chargemaster list. The Medicare allowed amount for this procedure is $1,222.56, which serves as a scientifically validated baseline for the true cost of care. Commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the price relative to this baseline. Although the data does not explicitly list state or county average comparisons for this specific code, patients should verify their plan's specific allowed amount before scheduling to ensure they are aware of their financial responsibility and to avoid unexpected balance billing, especially if services are rendered by out-of-network providers at this in-network facility.