Colonoscopy (diagnostic)
Facility: Republic County Hospital
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $970
- Cash Discount Price: $849
- vs. Medicare Baseline: 1.02x 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 |
|---|---|---|
| Rural Carriers-All Plans | $128 - $1,797 | 13% |
| Aetna | $135 - $1,903 | 14% |
| Meritain-All Plans | $135 - $1,903 | 14% |
| UnitedHealthcare | $138 - $1,945 | 15% |
| First Health-All Plans | $142 - $2,008 | 15% |
| Cigna | $142 - $2,008 | 15% |
| Midlands Choice-All Plans | $142 - $2,008 | 15% |
Consumer Guidance & Cost Commentary
For a diagnostic colonoscopy at Republic County Hospital in Belleville, KS, the cash price is $849.00, which is lower than the facility's gross charge of $1,132.00. While the hospital's negotiated rates with major payers like Aetna and UnitedHealthcare range from $135 to $2,008, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket and seeking a prompt-pay discount. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients should still verify their specific plan details before scheduling to ensure they are not inadvertently triggering unexpected charges.
The facility's cash rate of $849.00 is significantly lower than the Medicare benchmark of $950.10, suggesting a pricing structure that aligns closely with the true cost of care rather than inflated chargemaster lists. Although the median negotiated payment across payers is $146.00, this figure reflects the amount insurers actually pay after applying deductibles and copays, not the total cost to the patient. Consumers should request an itemized bill to review specific CPT codes and avoid summary bills that may hide unbundled charges or services not rendered, and they should explicitly ask the billing department about self-pay discounts or prompt-pay incentives before finalizing any appointment.