Colonoscopy with biopsy
Facility: Kearny County Hospital
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $2,596
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.12x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 212% of the Medicare baseline (a markup of 112%). 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 |
|---|---|---|
| Benefit Plan Administrators | $929 | 76% |
| UnitedHealthcare | $929 - $3,462 | 76% |
| Blue Cross Blue Shield | $929 - $5,194 | 76% |
| Aetna | $2,596 | 212% |
| Wps Gha - Mac J5 Part A | $4,328 | 354% |
Consumer Guidance & Cost Commentary
For a colonoscopy with biopsy at Kearny County Hospital in Lakin, KS, the facility's negotiated rates range from $929 to $5,194 depending on the insurance carrier, with a median negotiated payment of $2,596. This commercial rate is significantly higher than the Medicare benchmark of $1,222.56, reflecting the typical administrative markup inherent in insurance contracts. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that cash-pay options are not currently listed for this service. However, it is always advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can sometimes offer substantial savings compared to the standard negotiated rates charged to insured members.
The data indicates that while the facility's lowest negotiated rate of $929 matches the gross charge, other payers like UnitedHealthcare and Blue Cross Blue Shield have higher ceilings, with the latter reaching up to $5,194. This variation highlights the importance of verifying specific plan allowances before scheduling, as in-network rates can differ widely even within the same facility. Given that over 80% of hospital bills contain errors, patients should request a detailed, itemized bill rather than accepting a summary invoice to ensure no unbundled codes or services not rendered are included. If a balance bill arises from out-of-network ancillary services, the No Surprises Act provides federal protections that may allow for a dispute with the insurance carrier to prevent unexpected charges.