Colonoscopy (diagnostic)
Facility: Labette Health
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $593
- Cash Discount Price: $475
- vs. Medicare Baseline: 0.62x 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 |
|---|---|---|
| Aetna | $157 | 17% |
| Kansas Superior Select | $170 - $868 | 18% |
| Montgomery County | $176 - $1,543 | 19% |
| Uhccp | $234 | 25% |
| Medicaid / KanCare | $305 - $843 | 32% |
| Multiplan | $576 | 61% |
| Health Partners Of Kansas, Inc | $610 | 64% |
| Choicecare (First Health Network) | $610 | 64% |
| Ambetter / Centene | $678 | 71% |
| UnitedHealthcare | $843 | 89% |
| Blue Cross Blue Shield | $843 - $1,321 | 89% |
| Wellcare | $843 | 89% |
| Humana | $843 | 89% |
Consumer Guidance & Cost Commentary
For this diagnostic colonoscopy at Labette Health in Parsons, KS, the facility's cash price of $475.00 is significantly lower than the gross charge of $678.00 and the Medicare benchmark of $950.10. While the facility is a government-owned acute care hospital, its negotiated rates vary widely among payers; for instance, Aetna members face a flat rate of $157, whereas UnitedHealthcare and Blue Cross Blue Shield members may see charges ranging from $843 to $1,321. Because the cash price is often lower than many commercial negotiated rates, patients with high-deductible plans or those without insurance may save money by paying self-pay directly. It is important to verify the specific "self-pay" or "prompt-pay" discount available at the time of scheduling, as these upfront incentives can bypass the administrative costs and higher negotiated ceilings that insurance billing structures often impose.
Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network emergency services at in-network facilities, unexpected ancillary charges or non-covered items could still result in additional bills. To ensure accuracy, consumers should request a full itemized CPT-coded 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. Given that the median negotiated rate across payers is $593.00, which is higher than the cash price, it is advisable to confirm your specific plan's allowed amount before the procedure. If you receive a bill exceeding the cash price or Medicare rate, you have the right to dispute any balance billing or billing