Colonoscopy (diagnostic)
Facility: Greeley County Health Services
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $234
- Cash Discount Price: $952
- vs. Medicare Baseline: 0.25x 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 |
|---|---|---|
| Veterans Affairs Community Care Network | $230 | 24% |
| Medicare (plans) | $230 | 24% |
| Aetna | $234 | 25% |
| Medicaid / KanCare | $234 | 25% |
| Blue Cross Blue Shield | $1,714 | 180% |
Consumer Guidance & Cost Commentary
For this diagnostic colonoscopy at Greeley County Health Services in Tribune, Kansas, the facility's cash price of $952 is lower than the state average, which typically ranges from 10% to 20% higher for similar procedures. While commercial insurers like Aetna and Medicaid/KanCare have negotiated rates of $234, these amounts are significantly lower than the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly if their insurance coverage does not yet cover the deductible. However, it is important to note that commercial negotiated rates often include administrative overhead and do not reflect the true cost of care; comparing these rates to the Medicare benchmark of $950.1 reveals that the commercial rates are roughly 20% higher than the federal baseline, which is considered fair pricing.
Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, they should still request a prompt-pay discount before scheduling to avoid unexpected costs. If you choose to use insurance, ensure you have a signed waiver of insurance submission to prevent the hospital from automatically billing your plan and then attempting to collect the difference if the claim is denied. Always demand a full itemized bill before paying, as summary invoices can hide unbundled charges or services not rendered. Given that over 80% of hospital bills contain errors, reviewing the line-by-line details is the most effective way to ensure you are only paying for the actual services provided.