Colonoscopy (diagnostic)
Facility: Scott County Hospital
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $1,510
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.59x 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 |
|---|---|---|
| UnitedHealthcare | $296 - $2,391 | 31% |
| Humana | $1,057 | 111% |
| Wppa | $1,200 - $1,510 | 126% |
| Blue Cross Blue Shield | $1,321 | 139% |
| Aetna | $2,265 | 238% |
Consumer Guidance & Cost Commentary
For a diagnostic colonoscopy at Scott County Hospital in Scott City, KS, the facility's negotiated rates range from $1,057 to $2,391 depending on your specific insurance plan, with UnitedHealthcare offering the lowest allowed amount at $296 and Aetna the highest at $2,265. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the data indicates no specific cash or median paid rates are available for this service. It is important to note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract dynamics; therefore, patients with high-deductible plans or those without insurance may find self-pay or prompt-pay discounts more cost-effective than relying on insurance coverage.
To ensure you are not overcharged, always request a full itemized bill before finalizing payment, as summary invoices can obscure individual line items and potential errors. Since over 80% of hospital bills contain mistakes, such as unbundled codes or services not rendered, verifying the exact CPT codes and unit costs is a critical step in reducing medical debt. Additionally, while the facility's pricing structure is unique, comparing your specific allowed amount to the Medicare benchmark of $950.10 provides a clear baseline for evaluating the markup; commercial rates are typically higher than this federal standard, but fair pricing generally falls between 120% and 150% of the Medicare amount.