Colonoscopy (diagnostic)
Facility: Mitchell County Hospital Health Systems
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $211
- Cash Discount Price: $223
- vs. Medicare Baseline: 0.22x 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 | $154 - $302 | 16% |
| First Health-All Plans | $210 | 22% |
| Aetna | $210 | 22% |
| Triwest Well Mark All Plans | $211 | 22% |
| Health Partners Ks-All Plans | $662 | 70% |
Consumer Guidance & Cost Commentary
For a diagnostic colonoscopy at Mitchell County Hospital Health Systems in Beloit, KS, the facility's cash median rate of $223.00 is significantly lower than the gross charge of $248.00, offering a potential savings for patients with high-deductible plans who may not have insurance coverage. While the facility's negotiated rates with major payers like UnitedHealthcare range from $154 to $302, and the median negotiated amount is $211.00, these insurance-based prices often exceed the cash price due to administrative overhead and contract structures. It is important to note that while the facility is a Critical Access Hospital with a government-local ownership structure, patients should verify their specific plan details, as commercial negotiated rates can sometimes be higher than self-pay options. Additionally, the facility's rating of 3 and location in zip code 67420 suggest a standard regional setting, but the most critical factor for cost savings remains the decision to pay cash directly or utilize prompt-pay discounts before the bill is finalized.
When reviewing your bill, it is essential 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 that can inflate your total. Comparing this service to the Medicare benchmark of $950.10 reveals that the facility's cash and negotiated rates are well below the federal baseline, which serves as a scientifically validated measure of true care costs. Although the Medicare amount is substantially higher, the commercial rates provided here reflect the actual market dynamics for this procedure. To ensure you are not overcharged, always check for "self-pay" or