Colonoscopy with biopsy
Facility: Wichita County Health Center
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $1,163
- Cash Discount Price: $1,051
- vs. Medicare Baseline: 0.95x 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 |
|---|---|---|
| Medicaid / KanCare | $339 - $1,426 | 28% |
| UnitedHealthcare | $900 - $1,728 | 74% |
Consumer Guidance & Cost Commentary
For the Colonoscopy with biopsy procedure at Wichita County Health Center in Leoti, KS, the facility's cash median price of $1,051.00 is lower than the state average for this service. While Medicaid / KanCare members face a negotiated range of $339 to $1,426 and UnitedHealthcare members face a range of $900 to $1,728, patients with high-deductible plans may find paying the cash price directly more affordable if their insurance negotiated rate exceeds $1,051.00. It is important to note that commercial negotiated rates often include administrative overhead and can be significantly higher than the cash price, so verifying your specific plan's allowed amount before scheduling is essential to avoid unexpected costs.
To ensure you are not overcharged, request a full itemized bill that lists every CPT code and unit cost, as summary bills often hide unbundled charges or services not rendered. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is still wise to dispute any unexpected bills in writing rather than accepting summary invoices. Additionally, ask the billing department about "prompt-pay" discounts, which can reduce the total amount due by 20% to 50% if you settle the account upfront, effectively bypassing the administrative costs associated with insurance claims processing.