Colonoscopy (diagnostic)
Facility: Minneola District Hospital
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $1,260
- Cash Discount Price: $884
- vs. Medicare Baseline: 1.33x 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 |
|---|---|---|
| Va Community Care Program-All Plans | $391 - $1,260 | 41% |
| Humana | $391 - $1,260 | 41% |
| UnitedHealthcare | $391 - $1,880 | 41% |
| Providrs Care Network-All Plans | $548 - $1,598 | 58% |
| Corporate Plan Management-All Plans | $548 - $1,598 | 58% |
| Preferred Health Care (Coventry)-All Other Plans | $580 - $1,692 | 61% |
| Triwest-All Plans | $580 - $1,692 | 61% |
| Phc (Coventry) Leased Network | $613 - $1,786 | 65% |
| Health Partners Of Kansas-All Plans | $613 - $1,786 | 65% |
| Aetna | $613 - $1,880 | 65% |
| Medicaid / KanCare | $645 - $1,880 | 68% |
| Blue Cross Blue Shield | $1,321 | 139% |
Consumer Guidance & Cost Commentary
For a diagnostic colonoscopy at Minneola District Hospital, the facility's cash median rate of $884.00 is 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 hospital's negotiated rates with major payers like UnitedHealthcare and Aetna range from $391 to $1,880, the cash price remains the most transparent baseline for comparison. It is important to note that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures; therefore, patients with high deductibles may find paying the cash rate directly more cost-effective than relying on insurance, provided they qualify for the facility's self-pay or prompt-pay discounts.
To ensure you receive the most accurate pricing, always request an itemized bill before finalizing payment, as summary invoices can obscure individual charges or unbundled services that should be consolidated. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to verify that all ancillary services, such as laboratory tests or anesthesia, are properly covered to avoid unexpected gaps. Finally, since this facility is a Critical Access Hospital in Kansas, comparing its rates to the local Medicare benchmark of $950.10 provides a scientifically validated baseline; the facility's cash rate falls below this benchmark, suggesting a competitive pricing model that aligns with fair market value standards.