Colonoscopy (diagnostic)
Facility: University Of Kansas Hospital
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $1,420
- Cash Discount Price: $1,572
- vs. Medicare Baseline: 1.49x 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 |
|---|---|---|
| Medicaid / KanCare | $296 | 31% |
| Blue Cross Blue Shield | $296 - $1,862 | 31% |
| UnitedHealthcare | $296 - $1,389 | 31% |
| Tricare | $868 | 91% |
| Workers Comp [503999901] | $868 - $1,420 | 91% |
| Ku Athletics [503200094] | $868 | 91% |
| Lasso Healthcare [503999926] | $868 | 91% |
| Triwest [503201703] | $868 | 91% |
| Aetna | $868 - $1,216 | 91% |
| Medicare (plans) | $868 - $886 | 91% |
| Humana | $868 - $886 | 91% |
| Devoted [503200068] | $868 | 91% |
| Allwell [503200078] | $894 | 94% |
| American Health Plans [503200968] | $912 | 96% |
| Centurion [5032000966] | $1,129 | 119% |
| Gallagher Bassett [5032000103] | $1,420 | 149% |
| Sedgwick Claims Management Services [53201618] | $1,420 | 149% |
| Alt Bnsf Railway Co [503301503] | $1,420 | 149% |
| Prime Health Services [503999912] | $1,420 | 149% |
| Ambetter / Centene | $1,476 | 155% |
| Wellfit [503301514] | $1,650 | 174% |
| Centivo [5032000982] | $1,650 | 174% |
| Oscar [503201609] | $1,650 | 174% |
| 6 Degrees Health [503999050] | $1,693 - $2,171 | 178% |
| Alt Wppa [5032000964] | $1,736 | 183% |
| Occunet [503999930] | $1,823 | 192% |
| Fort Hays State Student Athletes [5032000960] | $1,823 | 192% |
| Claimdoc [503301509] | $2,344 | 247% |
| Multiplan [503200057] | $2,344 | 247% |
| Advanced Medical Pricing Solutions [503301513] | $2,605 | 274% |
Consumer Guidance & Cost Commentary
For a diagnostic colonoscopy at University Of Kansas Hospital, the facility's cash price of $1,572 is significantly higher than the state average for this procedure, which is $881. While many commercial payers have negotiated rates ranging from $868 to $2,605, the cash rate remains the lowest option for patients without insurance coverage. It is important to note that for individuals with high-deductible plans, paying the cash price upfront can sometimes be more cost-effective than using insurance, as the negotiated rates paid by insurers often exceed the cash price. Patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees.
The facility's Medicare benchmark of $950.1 serves as a critical baseline for evaluating pricing fairness, with the cash rate representing a markup of 1.5 times the Medicare amount. Although the median negotiated rate across all payers is $1,420, the wide variance in allowed amounts—from $296 for Medicaid/KanCare to $2,605 for Advanced Medical Pricing Solutions—highlights the importance of verifying specific plan allowances before treatment. To ensure accuracy, patients should request a full itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If a balance bill arises from an out-of-network ancillary service, the No Surprises Act may provide protection against paying the difference, so patients should dispute any unexpected charges with their insurer rather than paying