Colonoscopy (diagnostic)
Facility: Kansas City Orthopaedic Institute
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $2,109
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.22x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 222% of the Medicare baseline (a markup of 122%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Aetna | $811 | 85% |
| UnitedHealthcare | $811 | 85% |
| Cigna | $858 | 90% |
| Blue Cross Blue Shield | $2,109 | 222% |
Consumer Guidance & Cost Commentary
For a diagnostic colonoscopy at the Kansas City Orthopaedic Institute in Leawood, KS, the negotiated rate for in-network patients is $2,109. This amount is significantly higher than the state average for this procedure, which is $950.10. While commercial insurance contracts often result in higher out-of-pocket costs due to administrative fees and network tiering, patients with high-deductible plans might find that paying the cash price directly is more affordable. Since the cash median is not listed in this report, it is important to contact the facility directly to inquire about self-pay or prompt-pay discounts, which can reduce the final bill by 20% to 50% if paid upfront.
Patients should be aware that the $2,109 negotiated rate represents the maximum amount an insurer will pay under contract, not necessarily the final amount owed. If you are uninsured or have a plan with a high deductible, you may be eligible for a self-pay discount that could lower the cost below the state average. Additionally, if you receive care from an out-of-network provider at this facility, the No Surprises Act protects you from balance billing for emergency services and non-emergency services at in-network hospitals. To ensure you are not overcharged, always request an itemized bill before paying and verify that all services listed were actually rendered, as over 80% of hospital bills contain errors that can be corrected through a formal audit dispute.