Colonoscopy with biopsy
Facility: Menorah Medical Center
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 |
|---|---|---|
| United | $382 - $3,331 | 31% |
| Amerigroup | $382 | 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 "Colonoscopy with biopsy" at Menorah Medical Center in Overland Park, KS, the facility's negotiated rates vary significantly depending on your insurance plan, ranging from a low of $382 to a high of $4,562. While the median negotiated rate across all payers is $1,802, this figure is notably higher than the Medicare benchmark of $1,222.56, indicating a markup of 150% relative to the federal government's cost-based standard. It is important to note that commercial insurance rates often include administrative overhead for claims processing, which can inflate the baseline price by 20% to 40% compared to direct cash payments.
Patients should be aware that paying cash or using a self-pay discount may result in lower out-of-pocket costs, particularly if your insurance plan has a high deductible or if the negotiated rate exceeds the cash price. Menorah Medical Center, a Proprietary Acute Care Hospital, offers prompt-pay discounts that can reduce the total bill by 20% to 50% if settled in full within 30 days, bypassing the administrative costs associated with insurance billing. To ensure you receive the best possible rate, it is recommended to request a formal itemized bill before scheduling and to explicitly ask for self-pay or prompt-pay classification at registration, as hospitals may default to insurance processing if a card is on file without prior authorization.