Colonoscopy with biopsy
Facility: Labette Health
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $758
- Cash Discount Price: $606
- 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 $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 | $171 | 14% |
| Kansas Superior Select | $185 - $1,123 | 15% |
| Montgomery County | $191 - $1,996 | 16% |
| Uhccp | $234 | 19% |
| Medicaid / KanCare | $390 - $1,090 | 32% |
| Multiplan | $736 | 60% |
| Choicecare (First Health Network) | $779 | 64% |
| Health Partners Of Kansas, Inc | $779 | 64% |
| Ambetter / Centene | $866 | 71% |
| Humana | $1,090 | 89% |
| Blue Cross Blue Shield | $1,090 - $1,364 | 89% |
| Wellcare | $1,090 | 89% |
| UnitedHealthcare | $1,090 | 89% |
Consumer Guidance & Cost Commentary
For the Colonoscopy with biopsy (CPT 45380) at Labette Health in Parsons, KS, the cash median price is $606.00, which is lower than the facility's gross charge of $866.00. While commercial insurance negotiated rates range from $171 to $1,364 depending on the plan, patients with high-deductible plans may find paying cash directly more cost-effective if their insurance allowed amount exceeds the cash price. It is important to note that commercial rates often include administrative overhead and are frequently higher than the cash price due to multi-layered billing structures. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower the final cost by bypassing the administrative costs associated with insurance claims processing.
This facility is a government-owned acute care hospital in Kansas, and its pricing is benchmarked against federal standards. The Medicare amount for this service is $1,222.56, which serves as the objective baseline for evaluating commercial markups; fair pricing is typically defined as 120% to 150% of this rate, whereas commercial negotiated rates often average 200% to 300% of Medicare. Because the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, patients should be cautious of unexpected bills and should always request a full itemized CPT-coded bill before paying. If a patient receives a summary bill or faces a dispute, they should send a formal written audit dispute to the billing supervisor rather than accepting the initial invoice or settling verbally, as over 80%