Colonoscopy (diagnostic)
Facility: Cheyenne County Hospital
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $1,364
- Cash Discount Price: $978
- vs. Medicare Baseline: 1.44x 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 |
|---|---|---|
| First Health - All Plans | $191 - $1,420 | 20% |
| Firstguard - All Plans | $218 - $1,623 | 23% |
| Wppa - All Plans | $246 - $1,826 | 26% |
| Cpm - All Plans | $259 - $1,928 | 27% |
| Aetna | $259 - $1,928 | 27% |
| Preferred Hc - All Plans | $259 - $1,928 | 27% |
| Midlands Choice - All Plans | $265 - $1,968 | 28% |
| Ppo Next - All Plans | $268 - $1,988 | 28% |
| Integrated Hp - All Plans | $268 - $1,988 | 28% |
| Unicare - All Plans | $268 - $1,988 | 28% |
| Health Partners - All Plans | $268 - $1,988 | 28% |
| Healthy Blue Mcaid - All Other Plans | $273 - $2,029 | 29% |
| Childrens Mercy - All Plans | $273 - $2,029 | 29% |
| Healthwave Mcaid - All Plans | $273 - $2,029 | 29% |
| Tricare | $289 - $1,461 | 30% |
| Healthy Blue Mcr Adv | $289 - $1,461 | 30% |
| UnitedHealthcare | $289 - $2,029 | 30% |
| Choice Care - All Plans | $319 - $1,475 | 34% |
| Providers Care-All Plans | $410 - $3,044 | 43% |
| Blue Cross Blue Shield | $1,308 | 138% |
Consumer Guidance & Cost Commentary
For a diagnostic colonoscopy at Cheyenne County Hospital, the cash price is $978, which is lower than the facility's negotiated rates for most insurance plans but higher than the Medicare benchmark of $950.10. While the facility's cash rate is competitive, patients with high-deductible plans may find it beneficial to pay out-of-pocket if their insurance negotiated rates exceed this amount, as the cash price avoids the administrative overhead and markup inherent in commercial billing. It is important to note that the facility's cash rate is significantly lower than the gross charges listed on chargemasters, which often inflate the perceived cost of care; however, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront incentives can further reduce the final bill by bypassing the costly insurance claims cycle.
The facility's negotiated rates vary widely among payers, ranging from a low of $191 to a high of $3,044, with the highest negotiated rate for UnitedHealthcare at $1,308. This variation highlights that being in-network does not guarantee the lowest possible price, as different insurers contract at different levels. To ensure you are not overpaying, it is recommended to request an itemized billing audit before finalizing payment, as summary bills often obscure individual line items that may contain errors or unbundled charges. Additionally, since Medicare rates serve as a scientifically validated baseline for the true cost of care, comparing your specific plan's allowed amount against the Medicare benchmark can reveal if the commercial rate is marked up beyond fair pricing standards.