Colonoscopy (diagnostic)
Facility: Kiowa County Memorial Hospital
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $1,321
- Cash Discount Price: $861
- vs. Medicare Baseline: 1.39x 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 |
|---|---|---|
| UnitedHealthcare | $164 - $1,820 | 17% |
| Health Partners Of Ks-All Plans | $180 - $1,602 | 19% |
| Blue Cross Blue Shield | $182 - $1,620 | 19% |
| Aetna | $182 - $1,620 | 19% |
| Medica Prime Mcare Cost-All Plans | $182 - $1,620 | 19% |
| Humana | $182 - $1,620 | 19% |
| Celtic Comml Exchange-All Other Plans | $182 - $1,620 | 19% |
| Medicaid / KanCare | $205 - $1,820 | 22% |
| Providrs Care/Wppa-All Plans | $308 - $2,730 | 32% |
Consumer Guidance & Cost Commentary
For this diagnostic colonoscopy at Kiowa County Memorial Hospital in Greensburg, KS, the cash price is $861.00, which is lower than the facility's gross charge of $1,013.00. While the hospital is a government-owned Critical Access Hospital serving the 67054 zip code, patients should be aware that commercial insurance rates often exceed cash prices due to administrative overhead. For instance, the median negotiated rate across payers is $1,321.00, and individual payer ranges for this service span from $164 to $2,730. If you have a high-deductible plan where you have not yet met your deductible, paying the cash price of $861.00 upfront could save you money compared to the insurance allowed amount, especially if the insurer's negotiated rate is higher than the cash rate.
It is important to distinguish between the facility's gross charges and the Medicare benchmark of $950.10, which serves as the objective baseline for evaluating pricing markups. Commercial rates frequently average 200% to 300% of Medicare, whereas fair pricing is typically defined as 120% to 150% of this benchmark. Before scheduling, you should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% if paid in full within 30 days. Additionally, if you are using insurance, verify your deductible status beforehand, as paying the full negotiated rate without meeting your deductible can result in significantly higher out-of-pocket costs than paying cash directly.