Colonoscopy with biopsy
Facility: Hodgeman County Health Center
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $1,557
- Cash Discount Price: $1,769
- vs. Medicare Baseline: 1.27x 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 |
|---|---|---|
| Blue Cross Blue Shield | $1,295 - $1,364 | 106% |
| Triwest - All Plans | $1,415 | 116% |
| UnitedHealthcare | $1,415 - $2,100 | 116% |
| Humana | $1,415 | 116% |
| Medicaid / KanCare | $1,415 - $2,211 | 116% |
| Aetna | $1,769 | 145% |
| First Health - All Plans | $1,990 | 163% |
| Health Partners - All Plans | $2,100 | 172% |
| Wppa (Provdrscare) - All Plans | $2,100 | 172% |
Consumer Guidance & Cost Commentary
For the Colonoscopy with biopsy procedure at Hodgeman County Health Center in Jetmore, Kansas, the facility's cash price of $1,769 is significantly lower than the average negotiated rates charged by major insurers, which range from $1,295 to $2,211 depending on the plan. While the facility's cash rate is higher than the state average for this service, it remains below the gross chargemaster price of $2,211 and aligns closely with the cash median of $1,769. Patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount, potentially leaving patients responsible for significant out-of-pocket costs after deductibles are met.
To minimize unexpected costs, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. If you choose to use insurance, be aware that while the No Surprises Act protects you from balance billing for emergency care and non-emergency services at in-network facilities, it is crucial to verify that all ancillary services, such as specific lab tests or physician components, are truly in-network to avoid surprise charges. Additionally, if you receive a bill, always demand a full itemized statement showing specific CPT codes rather than accepting a summary invoice, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.