Colonoscopy with biopsy
Facility: Goodland Regional Medical Center
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $1,364
- Cash Discount Price: $1,746
- vs. Medicare Baseline: 1.12x 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 |
|---|---|---|
| Wppa | $1,003 - $2,430 | 82% |
| UnitedHealthcare | $1,062 - $2,430 | 87% |
| Blue Cross Blue Shield | $1,364 | 112% |
Consumer Guidance & Cost Commentary
For a colonoscopy with biopsy at Goodland Regional Medical Center in Goodland, KS, the cash median price is $1,746.00, which is lower than the facility's gross charge of $1,940.00. While the facility is a Critical Access Hospital with government local ownership, patients should note that commercial insurance negotiated rates can sometimes exceed cash prices; for instance, UnitedHealthcare and Wppa have negotiated ranges starting at $1,062 and $1,003 respectively, but the median negotiated rate across payers is $1,364.00. This suggests that for individuals with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price directly may result in lower total costs compared to using insurance, provided the patient understands their specific plan's deductible status before scheduling.
To ensure you are not overcharged, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, since this facility is in-network for three major payers, the No Surprises Act protects you from balance billing for emergency care and non-emergency services from out-of-network providers at this location. However, if you choose to pay out-of-network or if ancillary services like lab work are billed separately, you should verify that any additional charges comply with federal protections. Finally, always ask the billing department about "self-pay" or "prompt-pay" discounts upfront, as paying in full within a short window can often reduce the final amount owed by 20% to 50% by bypassing