Colonoscopy (diagnostic)
Facility: Wichita County Health Center
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $1,135
- Cash Discount Price: $1,024
- vs. Medicare Baseline: 1.19x 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 | $339 - $1,370 | 36% |
| UnitedHealthcare | $900 - $1,661 | 95% |
Consumer Guidance & Cost Commentary
For a diagnostic colonoscopy at Wichita County Health Center in Leoti, Kansas, the facility's negotiated rates range from $900 to $1,661 depending on the insurance plan, with a median negotiated amount of $1,135. This commercial rate is 20% higher than the Medicare benchmark of $950.10, reflecting the typical administrative markup and contract dynamics that often inflate commercial pricing above the federal baseline. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that in-network insurance plans may result in higher out-of-pocket costs compared to paying cash directly, as the cash median price is $1,024.00.
To minimize costs, patients with high-deductible plans should consider paying the cash price upfront, as this avoids the administrative overhead and negotiated rate structures that insurance carriers impose. Before scheduling, it is essential to explicitly request "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% by bypassing the costly claims processing cycle. Additionally, because over 80% of hospital bills contain errors, patients should never accept a summary invoice as final; instead, they must demand a full itemized audit to verify that no unbundled codes or services not rendered have been charged.