Colonoscopy with biopsy
Facility: University Of Ks Hlth System Great Bend Campus
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $1,873
- Cash Discount Price: $1,334
- vs. Medicare Baseline: 1.53x 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 |
|---|---|---|
| Workers Comp [503999901] | $1,117 - $1,873 | 91% |
| Ku Athletics [503200094] | $1,117 | 91% |
| UnitedHealthcare | $1,117 | 91% |
| Medicare (plans) | $1,140 | 93% |
| Blue Cross Blue Shield | $1,151 - $1,474 | 94% |
| Allwell [503200078] | $1,151 | 94% |
| Triwest [503201703] | $1,179 | 96% |
| Humana | $1,179 | 96% |
| Tricare | $1,179 | 96% |
| Centurion [5032000966] | $1,452 | 119% |
| Ambetter / Centene | $1,620 | 133% |
| Gallagher Bassett [5032000103] | $1,873 | 153% |
| Prime Health Services [503999912] | $1,873 | 153% |
| Sedgwick Claims Management Services [53201618] | $1,873 | 153% |
| Alt Bnsf Railway Co [503301503] | $1,873 | 153% |
| Occunet [503999930] | $2,346 | 192% |
| Fort Hays State Student Athletes [5032000960] | $2,346 | 192% |
| 6 Degrees Health [503999050] | $2,793 | 228% |
| Advanced Medical Pricing Solutions [503301513] | $3,536 | 289% |
Consumer Guidance & Cost Commentary
For a colonoscopy with biopsy at the University of KS Health System Great Bend Campus, the facility's cash price of $1,334 is significantly lower than the typical negotiated rates paid by insurance plans, which range from $1,117 to $3,536 across 19 payers. While the facility's cash rate is competitive, it is important to note that many commercial payers, including Workers Comp and various health networks, have negotiated rates that exceed this cash price. This dynamic suggests that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price directly could result in lower total costs compared to having insurance process the claim at a higher negotiated rate. Patients should verify their specific plan's deductible status and ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are utilizing the most cost-effective option available.
The facility's billing practices align with federal protections against surprise billing, as the No Surprises Act generally prevents balance billing for out-of-network providers at in-network facilities. However, patients should remain vigilant regarding itemized billing, as hospitals often issue summary bills that obscure individual charges; requesting a detailed, line-by-line statement is essential to identify errors, unbundled codes, or services not rendered. When evaluating the facility's pricing, it is more accurate to compare the allowed amount against the Medicare benchmark of $1,222.56 rather than the gross chargemaster price of $6,670, as Medicare rates represent a scientifically validated baseline for the true cost of care. By understanding these distinctions and actively requesting itemized audits or cash discounts, patients can avoid unexpected financial burdens and