Colonoscopy (diagnostic)
Facility: Morris County Hospital
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $1,288
- Cash Discount Price: $1,470
- vs. Medicare Baseline: 1.36x 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $427 | 45% |
| Coventry Mcr | $956 | 101% |
| UnitedHealthcare | $956 - $2,450 | 101% |
| Blue Cross Blue Shield | $956 - $1,321 | 101% |
| Choice Care Mcr Adv-All Plans | $956 | 101% |
| Va Ccn-All Plans | $956 | 101% |
| Cigna | $1,772 | 187% |
| Aetna | $2,195 | 231% |
| Multiplan-All Plans | $2,205 | 232% |
| Coventry Comm-All Other Plans | $2,205 | 232% |
Consumer Guidance & Cost Commentary
For a diagnostic colonoscopy at Morris County Hospital in Council Grove, KS, the cash price of $1,470 is notably lower than the facility's gross charge of $2,450 and the median negotiated rate of $1,288 paid by insurers. While the facility is a Critical Access Hospital with a government-local ownership structure, patients should be aware that commercial insurance plans often pay significantly higher amounts than cash prices; for instance, UnitedHealthcare's negotiated range spans from $956 to $2,450, and Aetna's rate is $2,195. If you have a high-deductible plan or have not yet met your deductible, paying the cash price of $1,470 upfront may result in lower out-of-pocket costs compared to the insurance negotiated rates, which can sometimes exceed the cash amount before your deductible is satisfied.
To ensure you are receiving the most accurate pricing, it is essential to request an itemized bill rather than accepting a summary invoice that obscures individual charges. Hospitals may inflate their chargemaster lists to make discounts appear larger, so comparing your final cost against the Medicare benchmark of $950.10 provides a more objective view of the facility's pricing than looking at the gross charge. Additionally, since this facility is located in Council Grove (ZIP 66846), you should verify if the local county or state average rates differ from the facility's specific pricing, and always ask about prompt-pay discounts or self-pay rates before scheduling to avoid unexpected balance billing or administrative fees associated with insurance claims processing.