Colonoscopy with biopsy
Facility: Meade District Hospital
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $1,790
- Cash Discount Price: $1,750
- vs. Medicare Baseline: 1.46x 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 |
|---|---|---|
| Blue Cross Blue Shield | $1,790 | 146% |
Consumer Guidance & Cost Commentary
For the procedure "Colonoscopy with biopsy" (CPT 45380) at Meade District Hospital in Meade, KS, the cash price is $1,750.00, which matches the facility's gross charge. This rate is significantly higher than the Medicare benchmark of $1,222.56, reflecting a markup of 1.5 times the federal baseline. While commercial insurance typically negotiates rates between 200% and 300% of Medicare, this facility's negotiated rate of $1,790.00 remains close to the cash price, suggesting limited room for further reduction through standard insurance channels. Because the cash price is already aligned with the gross charge, patients with high-deductible plans may find paying out-of-pocket directly to the hospital more cost-effective than relying on insurance, provided they can secure a prompt-pay discount.
Patients should proactively contact the hospital before scheduling to inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid in full upfront. Since the facility is a Critical Access Hospital owned by a Government Hospital District, it may offer specific financial assistance programs not available to commercial payers. It is important to verify your deductible status before using insurance, as paying the negotiated rate without meeting your deductible could result in higher out-of-pocket costs than the cash price. Additionally, ensure you receive an itemized bill containing specific CPT codes to avoid errors or unbundled charges, as over 80% of hospital bills contain discrepancies that can be resolved through a formal written audit.