Colonoscopy with biopsy
Facility: Republic County Hospital
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $1,030
- Cash Discount Price: $892
- vs. Medicare Baseline: 0.84x 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 |
|---|---|---|
| Rural Carriers-All Plans | $320 - $1,701 | 26% |
| Aetna | $339 - $1,801 | 28% |
| Meritain-All Plans | $339 - $1,801 | 28% |
| UnitedHealthcare | $347 - $1,841 | 28% |
| Cigna | $358 - $1,901 | 29% |
| Midlands Choice-All Plans | $358 - $1,901 | 29% |
| First Health-All Plans | $358 - $1,901 | 29% |
Consumer Guidance & Cost Commentary
For a colonoscopy with biopsy at Republic County Hospital in Belleville, KS, the cash price of $892.00 is notably lower than the facility's negotiated rates, which range from $320 to $1,901 depending on the insurance carrier. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance contracts often include administrative overheads that can inflate the final allowed amount. If you have a high-deductible plan, paying the cash price of $892.00 upfront might result in significant savings compared to your insurance's negotiated rate, which could exceed the cash price due to multi-layered billing structures. We recommend contacting the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these programs can further reduce the cost by bypassing standard claims processing fees.
This procedure's pricing is also contextualized against national benchmarks, where the cash median of $892.00 is compared to the Medicare amount of $1,222.56, indicating a ratio of 0.8. It is important to note that while commercial rates are often higher than Medicare, they are contractually capped to protect in-network members; however, these negotiated rates can still be higher than the cash price due to administrative costs. To ensure you are not overcharged, we advise requesting a full itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. By reviewing the detailed line items and disputing any inaccuracies in writing, you can effectively reduce medical debt and avoid paying for unnecessary charges.