Colonoscopy with biopsy
Facility: Mitchell County Hospital Health Systems
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $537
- Cash Discount Price: $572
- vs. Medicare Baseline: 0.44x 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 |
|---|---|---|
| UnitedHealthcare | $166 - $603 | 14% |
| Auxiant-All Plans | $523 | 43% |
| First Health-All Plans | $537 | 44% |
| Aetna | $537 | 44% |
| Triwest Well Mark All Plans | $540 | 44% |
| Health Partners Ks-All Plans | $795 | 65% |
Consumer Guidance & Cost Commentary
For a colonoscopy with biopsy at Mitchell County Hospital Health Systems in Beloit, KS, the facility's cash median price of $572.00 is lower than the state average for this procedure. While the hospital's negotiated rates with major payers like UnitedHealthcare and Auxiant-All Plans range from $523 to $603, these amounts often exceed the cash price, making self-pay a potentially more affordable option for patients with high-deductible plans. The facility, a Critical Access Hospital owned by the local government, lists a cash median of $572.00, which is notably lower than the Medicare benchmark of $1,222.56, suggesting that commercial contracts or cash payments may offer significant savings compared to standard government reimbursement rates.
Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is still crucial to verify your specific plan's allowed amount before scheduling. If you choose to pay out-of-pocket, ask the billing department about "prompt-pay" discounts, which can further reduce the cost by paying upfront. Additionally, if you receive an itemized bill, request a full line-by-line audit to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected. Always compare the facility's negotiated rates against the broader market to confirm you are receiving fair pricing for this essential service.