Colonoscopy (diagnostic)
Facility: Wilson Medical Center
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $1,742
- Cash Discount Price: $1,634
- vs. Medicare Baseline: 1.83x 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 |
|---|---|---|
| Ambetter / Centene | $1,154 - $2,178 | 121% |
| Humana | $1,154 | 121% |
| UnitedHealthcare | $1,154 - $2,026 | 121% |
| Tricare | $1,154 | 121% |
| Aetna | $1,154 - $2,178 | 121% |
| Blue Cross Blue Shield | $1,308 - $2,178 | 138% |
| Cigna | $1,742 | 183% |
| Health Partners-All Plans | $2,004 | 211% |
| Mulitplan-All Plans | $2,004 | 211% |
Consumer Guidance & Cost Commentary
For a diagnostic colonoscopy at Wilson Medical Center in Neodesha, KS, the facility's cash price of $1,634 is lower than the state average but higher than the county average. While Medicare sets a benchmark of $950.10, commercial insurance plans typically pay between $1,154 and $2,178 depending on the carrier, with most negotiated rates falling between $1,308 and $2,004. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $1,634 rate is often lower than the amount their insurance would negotiate to pay. It is important to verify your specific deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can result in significant out-of-pocket costs.
To maximize savings, patients should proactively request "self-pay" or "prompt-pay" discounts from the hospital before check-in, which can reduce the final bill by 20% to 50%. Because hospitals often submit claims to insurance automatically, patients must sign a waiver of insurance submission to ensure the cash discount applies. Additionally, if you are concerned about potential balance billing or billing errors, always request a detailed, itemized bill that lists every CPT code and charge rather than accepting a summary invoice. Given that over 80% of hospital bills contain errors, a thorough review of the line items is the most effective way to identify and correct mistakes before payment.