Colonoscopy (diagnostic)
Facility: University Of Ks Hlth System Great Bend Campus
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $1,290
- Cash Discount Price: $758
- vs. Medicare Baseline: 1.36x 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 |
|---|---|---|
| Medicaid / KanCare | $296 | 31% |
| Blue Cross Blue Shield | $296 - $1,321 | 31% |
| UnitedHealthcare | $296 - $868 | 31% |
| Ku Athletics [503200094] | $868 | 91% |
| Workers Comp [503999901] | $868 - $1,420 | 91% |
| Medicare (plans) | $886 | 93% |
| Allwell [503200078] | $894 | 94% |
| Humana | $916 | 96% |
| Tricare | $916 | 96% |
| Triwest [503201703] | $916 | 96% |
| Centurion [5032000966] | $1,129 | 119% |
| Ambetter / Centene | $1,259 | 133% |
| Sedgwick Claims Management Services [53201618] | $1,420 | 149% |
| Gallagher Bassett [5032000103] | $1,420 | 149% |
| Alt Bnsf Railway Co [503301503] | $1,420 | 149% |
| Prime Health Services [503999912] | $1,420 | 149% |
| Fort Hays State Student Athletes [5032000960] | $1,823 | 192% |
| Occunet [503999930] | $1,823 | 192% |
| 6 Degrees Health [503999050] | $2,171 | 229% |
| Advanced Medical Pricing Solutions [503301513] | $2,748 | 289% |
Consumer Guidance & Cost Commentary
For this diagnostic colonoscopy at the University of KS Health System Great Bend Campus, the facility's cash price of $758 is significantly lower than the negotiated rates charged to most insurance plans, which range from $296 to $2,748 depending on the payer. While the facility's negotiated average of $1,290 is higher than the cash rate, it is important to note that commercial rates often include administrative overhead and are not always the lowest option for patients. If you have a high-deductible plan or have not yet met your deductible, paying the cash price of $758 upfront could result in substantial savings compared to the insurance allowed amount, which may be higher than the cash rate. Additionally, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill if paid in full before services are rendered.
The facility's pricing is benchmarked against Medicare, which sets a fixed rate of $950.10 for this procedure. The cash price of $758 is lower than the Medicare rate, indicating that the facility's self-pay pricing is already competitive relative to the federal baseline. However, many commercial payers negotiate rates that exceed the Medicare benchmark, such as UnitedHealthcare and Workers Comp, which have high-end negotiated rates of $868 and $1,420 respectively. Because balance billing is generally prohibited for in-network services at this facility under the No Surprises Act, patients should not expect to be billed the difference between the chargemaster and their insurance allowed amount. To ensure you receive the most accurate and transparent pricing, always request a full itemized bill before paying,