Colonoscopy (diagnostic)
Facility: Overland Park Reg Med Ctr
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $1,770
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.86x 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 |
|---|---|---|
| United | $296 - $3,181 | 31% |
| Amerigroup | $296 | 31% |
| Healthyblue | $302 | 32% |
| Medicaid / KanCare | $305 | 32% |
| Unicare | $308 | 32% |
| Aetna | $308 - $2,417 | 32% |
| Home State Health Plan | $816 | 86% |
| Multiplan | $1,136 - $4,562 | 120% |
| Corvel Corporation | $1,349 | 142% |
| Oha Network | $1,406 | 148% |
| Humana | $1,770 - $2,192 | 186% |
| Universal Healthcare | $1,995 | 210% |
| Cigna | $2,460 - $3,668 | 259% |
| Nhc Advantage | $2,550 | 268% |
| Oscar | $3,122 | 329% |
Consumer Guidance & Cost Commentary
For the diagnostic colonoscopy procedure at Overland Park Reg Med Ctr, the facility's negotiated rates range from $296 to $4,562 depending on the insurance carrier, with a median negotiated amount of $1,770. This facility is located in Overland Park, Kansas (ZIP 66215), and its pricing structure is significantly higher than the national benchmark; the commercial negotiated rate is 1.9 times the Medicare amount of $950.10. While the facility is a Proprietary Acute Care Hospital with a 4-star rating, patients should be aware that in-network insurance plans often pay rates that exceed the actual cost of care due to administrative overhead and contract dynamics. If you have a high-deductible plan where your deductible has not yet been met, the insurance company may pay the full negotiated rate, meaning you could end up paying a substantial portion of the bill out of pocket.
To potentially lower your out-of-pocket costs, it is advisable to inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the total bill by 20% to 50% for upfront payment. Since the facility's negotiated rates are often inflated by administrative processing costs, paying cash or via a prompt-pay discount before the insurance claim is submitted can bypass these markups and avoid balance billing scenarios. Before scheduling, verify your specific plan's allowed amount for CPT code 45378, as different payers like United, Aetna, and Multiplan have vastly different rate ceilings. Always request a full itemized bill prior to payment to ensure no unbundled codes or services not rendered are included