Colonoscopy with biopsy
Facility: Minneola District Hospital
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $1,647
- Cash Discount Price: $1,281
- vs. Medicare Baseline: 1.35x 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 |
|---|---|---|
| UnitedHealthcare | $1,226 - $1,830 | 100% |
| Va Community Care Program-All Plans | $1,226 | 100% |
| Humana | $1,226 | 100% |
| Blue Cross Blue Shield | $1,364 | 112% |
| Corporate Plan Management-All Plans | $1,556 | 127% |
| Providrs Care Network-All Plans | $1,556 | 127% |
| Preferred Health Care (Coventry)-All Other Plans | $1,647 | 135% |
| Triwest-All Plans | $1,647 | 135% |
| Phc (Coventry) Leased Network | $1,738 | 142% |
| Aetna | $1,738 - $1,830 | 142% |
| Health Partners Of Kansas-All Plans | $1,738 | 142% |
| Medicaid / KanCare | $1,830 | 150% |
Consumer Guidance & Cost Commentary
For this Colonoscopy with biopsy at Minneola District Hospital, the cash median price is $1,281, which is lower than the facility's gross charge of $1,830. While the facility is a Critical Access Hospital in Kansas, the data does not provide specific state or county average rates for comparison. However, the cash price is notably lower than the median negotiated rate of $1,647 paid by most insurance plans, including UnitedHealthcare, Humana, and Blue Cross Blue Shield. This difference highlights that for patients with high-deductible plans or those without coverage, paying the cash price directly can be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash price due to administrative overhead and contract dynamics.
Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it does not automatically eliminate all potential costs if ancillary services are billed separately. To minimize expenses, it is advisable to request a prompt-pay discount or self-pay rate before scheduling, as these discounts can further reduce the bill. Additionally, if you receive an itemized bill, review it carefully to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal audit. Always verify your specific plan's deductible status and allowed amounts with the hospital prior to receiving care to avoid unexpected financial burdens.