Colonoscopy with biopsy
Facility: Logan County Hospital
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $1,282
- Cash Discount Price: $756
- vs. Medicare Baseline: 1.05x 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 | $168 | 14% |
| Humana | $168 - $1,282 | 14% |
| Medicaid / KanCare | $391 - $3,022 | 32% |
| Blue Cross Blue Shield | $1,364 | 112% |
| Health Partners - All Plans | $2,871 | 235% |
Consumer Guidance & Cost Commentary
For a Colonoscopy with biopsy at Logan County Hospital in Oakley, KS, the facility's cash price of $756.00 is significantly lower than the median negotiated rate of $1,282.00 paid by insurers like Humana and Medicaid/KanCare. While the hospital is a Critical Access Hospital with government local ownership, patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the negotiated rates often exceed the cash amount. To secure the lowest possible cost, consumers should explicitly ask the billing department for "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees.
It is important to understand that commercial insurance rates are not set by the government but are negotiated contracts that often include administrative markups, whereas the Medicare benchmark of $1,222.56 serves as a more objective baseline for fair pricing. Although the data does not provide specific county or state average comparisons for this procedure, the significant gap between the cash price and the negotiated rates highlights how insurance contracts can inflate costs compared to direct payment. If you receive a bill from an out-of-network provider or encounter unexpected charges, you have the right to request an itemized audit to verify that all services rendered are accurately coded and that no balance billing violations have occurred under federal protections.