Colonoscopy with biopsy
Facility: Cheyenne County Hospital
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $1,441
- Cash Discount Price: $1,147
- vs. Medicare Baseline: 1.18x 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 |
|---|---|---|
| UnitedHealthcare | $289 - $2,188 | 24% |
| Tricare | $289 - $1,576 | 24% |
| Healthy Blue Mcr Adv | $289 - $1,576 | 24% |
| Aetna | $289 - $2,079 | 24% |
| Choice Care - All Plans | $319 - $1,591 | 26% |
| First Health - All Plans | $358 - $1,532 | 29% |
| Firstguard - All Plans | $409 - $1,751 | 33% |
| Wppa - All Plans | $460 - $1,970 | 38% |
| Preferred Hc - All Plans | $486 - $2,079 | 40% |
| Cpm - All Plans | $486 - $2,079 | 40% |
| Midlands Choice - All Plans | $496 - $2,123 | 41% |
| Ppo Next - All Plans | $501 - $2,145 | 41% |
| Unicare - All Plans | $501 - $2,145 | 41% |
| Health Partners - All Plans | $501 - $2,145 | 41% |
| Integrated Hp - All Plans | $501 - $2,145 | 41% |
| Healthy Blue Mcaid - All Other Plans | $512 - $2,188 | 42% |
| Healthwave Mcaid - All Plans | $512 - $2,188 | 42% |
| Childrens Mercy - All Plans | $512 - $2,188 | 42% |
| Providers Care-All Plans | $767 - $3,283 | 63% |
| Blue Cross Blue Shield | $1,350 | 110% |
Consumer Guidance & Cost Commentary
For CPT code 45380, a colonoscopy with biopsy, Cheyenne County Hospital in St. Francis, KS, lists a gross charge of $1,350.00. The facility's cash median price of $1,147.00 is lower than the state average for this procedure, offering a potential savings for patients who can pay directly. While the hospital's negotiated rates with insurance payers range from $289 to $3,283, the cash price may be more advantageous for individuals with high-deductible plans or those without coverage, as the cash rate is often lower than the commercial negotiated rates. Patients should verify if their specific plan has a deductible that would otherwise require them to pay the higher negotiated amount, and they are encouraged to ask the billing department about self-pay or prompt-pay discounts before scheduling to secure the best possible rate.
The Medicare benchmark for this service is $1,222.56, which serves as a reliable baseline for evaluating the facility's pricing. The hospital's cash rate of $1,147.00 is approximately 94% of the Medicare amount, indicating a competitive price point that aligns closely with the federal cost basis. In contrast, the median negotiated rate across payers is $1,441.00, which exceeds the Medicare benchmark by roughly 18%, reflecting the typical administrative markup associated with commercial insurance contracts. Given that over 80% of hospital bills contain errors, consumers should request a detailed, itemized bill to ensure no unbundled charges or services not rendered are included, and they should avoid accepting summary bills that obscure individual line items.