Colonoscopy (diagnostic)
Facility: Menorah Medical Center
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 - $3,331 | 31% |
| Amerigroup | $296 | 31% |
| Healthyblue | $302 | 32% |
| Medicaid / KanCare | $305 | 32% |
| Aetna | $308 - $2,417 | 32% |
| Unicare | $308 | 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 a diagnostic colonoscopy at Menorah Medical Center in Overland Park, Kansas, the facility's negotiated rates range from $296 to $4,562 depending on the insurance plan. The lowest negotiated rate of $296 is significantly lower than the facility's median negotiated rate of $1,770, while the highest rate of $4,562 exceeds the median substantially. It is important to note that cash payments are not listed for this procedure, meaning patients without insurance coverage cannot utilize potential cash-pay savings. Additionally, while the facility's median negotiated rate is well below the state average for this service, patients should be aware that commercial rates often include administrative overhead and may still be higher than the actual cost of care, which is reflected in the Medicare benchmark of $950.10.
Patients should exercise caution regarding balance billing, as out-of-network providers can bill the full chargemaster rate, though the No Surprises Act protects emergency and non-emergency services at in-network facilities from such surprise bills. If a patient receives a bill that appears higher than the negotiated rate, they should request an itemized billing audit to identify errors, double-billing, or unbundled codes, as over 80% of hospital bills contain inaccuracies. Furthermore, if a patient has a high deductible, paying cash upfront might be more cost-effective than relying on insurance, provided the facility offers a prompt-pay discount. To secure the best possible price, patients should contact the hospital directly to confirm their specific plan's allowed amount and ask about any self-pay or prompt-pay discounts before scheduling the procedure.