Colonoscopy (diagnostic)
Facility: Goodland Regional Medical Center
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $1,321
- Cash Discount Price: $1,647
- vs. Medicare Baseline: 1.39x 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 |
|---|---|---|
| Wppa | $888 - $2,354 | 93% |
| UnitedHealthcare | $940 - $2,354 | 99% |
| Blue Cross Blue Shield | $1,321 | 139% |
Consumer Guidance & Cost Commentary
For a diagnostic colonoscopy at Goodland Regional Medical Center in Goodland, Kansas, the cash median price is $1,647, which is notably higher than the state average. While the facility is a Critical Access Hospital with government local ownership, patients should be aware that cash payments can sometimes be more cost-effective than using insurance if their plan's negotiated rate exceeds the cash price. The data shows that while some payers like Wppa and UnitedHealthcare have negotiated rates ranging from $940 to $2,354, Blue Cross Blue Shield has a fixed negotiated rate of $1,321. Because commercial rates often include administrative overhead and contract markups, it is advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower the final cost.
When reviewing your final bill, it is crucial to request a full itemized statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you receive a bill, you should systematically review the line items for CPT codes to ensure no charges exist for supplies or tests that were never delivered or cancelled. Additionally, this service's Medicare amount is $950.10, and the facility's pricing is 1.4 times the Medicare rate, which serves as a reliable benchmark for evaluating the facility's markup. By comparing your specific negotiated or cash rate against this Medicare baseline and verifying your deductible status, you can avoid common pitfalls like paying high in-network rates before meeting your out-of-pocket threshold or inadvertently signing away rights to dispute out-of-network balance billing.