Colonoscopy (diagnostic)
Facility: Stanton County Hospital
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $1,044
- Cash Discount Price: $1,021
- vs. Medicare Baseline: 1.10x 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 |
|---|---|---|
| Healthy Blue Mcaid | $207 - $1,286 | 22% |
| Blue Cross Blue Shield | $230 - $1,321 | 24% |
| Healthy Blue Mcr Adv - All Other Plans | $238 - $1,261 | 25% |
Consumer Guidance & Cost Commentary
Stanton County Hospital, located at 404 N Chestnut in Johnson, Kansas, performed a diagnostic colonoscopy with a cash median price of $1,021 and a gross charge of $1,021. For this procedure, the facility's cash rate is identical to its gross charge, while the median negotiated rate for commercial payers is $1,044 and the median paid amount is also $1,044. Three payers submitted claims for this service, with Healthy Blue Mcaid, Blue Cross Blue Shield, and Healthy Blue Mcr Adv - All Other Plans reporting negotiated ranges between $207 and $1,321. The Medicare amount for this service is $950.10, which is 110% of the cash price.
Commercial insurance rates for this procedure are slightly higher than the cash price, meaning patients with high-deductible plans or those paying out-of-pocket might save money by paying the cash rate directly. It is important to note that while the facility is a Critical Access Hospital owned by the Government - Local, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payments can reduce the final bill. Additionally, patients should be aware of balance billing protections under the No Surprises Act, which prevents out-of-network providers at in-network facilities from charging the difference between the allowed amount and the full chargemaster rate for emergency and non-emergency services.