Colonoscopy (diagnostic)
Facility: Meade District Hospital
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $1,734
- Cash Discount Price: $900
- vs. Medicare Baseline: 1.83x 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 |
|---|---|---|
| Blue Cross Blue Shield | $1,734 | 183% |
Consumer Guidance & Cost Commentary
For a diagnostic colonoscopy at Meade District Hospital in Meade, Kansas, the cash price is $900.00, which matches the facility's median cash rate. This cash price is significantly lower than the negotiated rate of $1,734.00 paid by Blue Cross Blue Shield, the single payer listed for this service. While the facility is a Critical Access Hospital owned by the Government - Hospital District or Authority, patients with high-deductible plans may find paying the $900.00 cash price more cost-effective than relying on insurance, as the negotiated rate exceeds the cash amount. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients should still verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not charged the full negotiated amount.
The Medicare benchmark for this procedure is $950.10, which serves as a reliable baseline for evaluating the facility's pricing structure. Although the data does not provide specific state or county average comparisons for this code, the Medicare rate of $950.10 offers a clear reference point against which the $900.00 cash price can be measured. If a patient chooses to use insurance, they should be aware that the commercial negotiated rate of $1,734.00 includes administrative costs and contract dynamics that often inflate the price beyond the true cost of care. To avoid unexpected charges, patients should request a full itemized bill before paying, ensuring there are no unbundled codes or services not rendered, and should dispute any balance bills