Colonoscopy (diagnostic)
Facility: Wesley Medical Center
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $1,406
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.48x 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 |
|---|---|---|
| UnitedHealthcare | $296 | 31% |
| Medicaid / KanCare | $305 | 32% |
| Aetna | $308 - $2,454 | 32% |
| Amerigroup | $308 | 32% |
| Usa Managed Care | $711 | 75% |
| First Health | $1,349 | 142% |
| Multiplan | $1,406 | 148% |
| United | $2,704 | 285% |
| Blue Cross Blue Shield | $2,795 | 294% |
Consumer Guidance & Cost Commentary
For the diagnostic colonoscopy procedure at Wesley Medical Center in Wichita, KS, insurance negotiated rates vary significantly depending on your specific plan. While UnitedHealthcare and Medicaid / KanCare have fixed negotiated rates of $296 and $305 respectively, other payers like Aetna and Multiplan have ranges extending up to $2,795. The median negotiated rate across all nine payers is $1,406, which is 1.5 times the Medicare benchmark of $950.10. This markup is typical for commercial contracts, which often include administrative costs and risk premiums that exceed the federal baseline.
Patients should consider that cash-pay options may offer a lower total cost than using insurance, especially if your plan has a high deductible or if the negotiated rate exceeds the facility's cash price. Although the data does not list a specific cash median, hospitals frequently offer prompt-pay discounts of 20% to 50% for upfront payment, effectively bypassing the administrative overhead of claims processing. To secure the best price, you should contact the hospital directly to request a self-pay or prompt-pay rate before scheduling, as waiting until after receiving an insurance bill often results in higher charges. Additionally, ensure you do not sign any waivers that might void these discounts or inadvertently agree to balance billing for out-of-network ancillary services.