Colonoscopy (diagnostic)
Facility: Kearny County Hospital
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $3,029
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.19x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 319% of the Medicare baseline (a markup of 219%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Blue Cross Blue Shield | $156 - $5,194 | 16% |
| Community Care Health Plan Of | $822 - $3,462 | 87% |
| UnitedHealthcare | $822 - $3,462 | 87% |
| Luminare Health | $3,462 | 364% |
Consumer Guidance & Cost Commentary
For a diagnostic colonoscopy at Kearny County Hospital in Lakin, KS, the facility's negotiated rates range from $822 to $5,194 depending on your specific insurance plan, with a median paid amount of $1,205.00. This negotiated rate is significantly higher than the Medicare benchmark of $950.10, reflecting the administrative costs and contract dynamics inherent in commercial insurance billing. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that cash-pay options are often more economical. Although the cash median is not listed for this service, paying out-of-pocket can sometimes result in lower costs than the insurance negotiated rate, particularly for those with high-deductible plans where the insurer's allowed amount exceeds the cash price.
To ensure you are not overcharged, it is crucial to request a detailed, itemized bill before finalizing payment, as summary bills often obscure individual line items and potential errors. If you receive a balance bill for the difference between the provider's full charge and your insurance payment, you may be protected under the No Surprises Act, which bans such billing for emergency and non-emergency services at in-network facilities. Additionally, you should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can reduce your total cost by 20% to 50% if you settle the account upfront. Given that over 80% of hospital bills contain errors, obtaining a certified itemized statement is your most effective tool for verifying that all charges are accurate and necessary.