Colonoscopy with biopsy
Facility: Stanton County Hospital
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $1,321
- Cash Discount Price: $1,254
- vs. Medicare Baseline: 1.08x 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 |
|---|---|---|
| Healthy Blue Mcaid | $207 - $1,418 | 17% |
| Blue Cross Blue Shield | $230 - $1,364 | 19% |
| Healthy Blue Mcr Adv - All Other Plans | $238 - $1,389 | 19% |
Consumer Guidance & Cost Commentary
For a Colonoscopy with biopsy at Stanton County Hospital in Johnson, KS, the cash price is $1,254.00, which matches the facility's median paid amount. This cash rate is notably lower than the state average for this procedure, offering a potential savings opportunity for patients with high-deductible plans or those without insurance. While the facility's negotiated rates with major payers like Healthy Blue Mcaid and Blue Cross Blue Shield range from $207 to $1,418, these amounts often exceed the cash price due to administrative overhead and contract structures. Patients should verify their specific plan's deductible status before scheduling, as paying out-of-pocket might result in a lower total cost than the insurance allowed amount, especially if the patient has not yet met their deductible threshold.
To ensure you are not overcharged, it is crucial to request a full itemized bill before finalizing payment, as summary bills can obscure individual charges or unbundled services. If you receive a balance bill from an out-of-network provider, even at an in-network facility, you may have protections under the No Surprises Act that prevent you from paying the difference between the provider's full rate and your insurance payment. Additionally, ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the $1,254.00 cash price by 20% to 50% if paid in full upfront. Always dispute any unexpected charges in writing to avoid credit damage, ensuring that your final invoice reflects only the services rendered and the agreed-upon negotiated or cash rates.