Colonoscopy with biopsy
Facility: Overland Park Reg Med Ctr
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $1,802
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.47x 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 |
|---|---|---|
| Amerigroup | $382 | 31% |
| United | $382 - $3,181 | 31% |
| Healthyblue | $390 | 32% |
| Medicaid / KanCare | $394 | 32% |
| Unicare | $398 | 33% |
| Aetna | $398 - $2,417 | 33% |
| Home State Health Plan | $1,055 | 86% |
| Multiplan | $1,498 - $4,562 | 123% |
| Humana | $1,770 - $2,192 | 145% |
| Corvel Corporation | $1,779 | 146% |
| Oha Network | $1,854 | 152% |
| Universal Healthcare | $1,995 | 163% |
| Cigna | $2,460 - $3,668 | 201% |
| Nhc Advantage | $2,550 | 209% |
| Oscar | $3,122 | 255% |
Consumer Guidance & Cost Commentary
For the procedure code 45380 (Colonoscopy with biopsy) at Overland Park Reg Med Ctr, the facility's negotiated rates range from $382 to $4,562 across 15 different payers, with a median negotiated amount of $1,802. This commercial rate is significantly higher than the Medicare benchmark of $1,222.56, reflecting a markup of 1.5 times the federal rate. While many commercial payers offer rates between $382 and $3,181, the facility's cash price is not listed in this report. Patients with high-deductible plans should note that paying cash upfront could potentially be cheaper than the insurance negotiated rate if the facility offers a self-pay or prompt-pay discount, which typically reduces the bill by 20% to 50% for upfront payment.
To ensure you are not overcharged, it is critical to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you receive a surprise bill from an out-of-network provider at this in-network facility, the No Surprises Act may protect you from balance billing for emergency or non-emergency services, so you should dispute any unexpected charges with your insurer rather than paying immediately. Additionally, since the facility is located in Overland Park, KS, and operates as an Acute Care Hospital, you should verify your specific plan's deductible status and ask the billing department directly about any available self-pay discounts before scheduling your appointment.