Colonoscopy (diagnostic)
Facility: Neosho Memorial Regional Medical Center
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $388
- Cash Discount Price: $385
- vs. Medicare Baseline: 0.41x 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 |
|---|---|---|
| Tricare | $158 | 17% |
| Medicaid / KanCare | $296 | 31% |
| Medicare (plans) | $388 | 41% |
| Aetna | $388 | 41% |
| Humana | $388 | 41% |
| Medadv_Uhc | $388 | 41% |
| Va_Ccn | $388 | 41% |
| Medadv_Allwell | $388 | 41% |
| Blue Cross Blue Shield | $388 - $513 | 41% |
| Ambetter / Centene | $408 | 43% |
| Wppa_Providrscare | $426 | 45% |
| United | $427 | 45% |
| Cigna | $487 | 51% |
| Coventry | $487 | 51% |
| Hpk | $487 | 51% |
Consumer Guidance & Cost Commentary
For a diagnostic colonoscopy at Neosho Memorial Regional Medical Center in Chanute, KS, the facility's negotiated rates range from $158 for Tricare to $513 for Blue Cross Blue Shield, with a median negotiated amount of $388. This median rate is notably higher than the facility's cash price of $385 and the state median paid amount of $328. While the facility is a Critical Access Hospital with government ownership, patients should be aware that commercial insurance contracts often include administrative overhead that inflates the baseline price by 20% to 40% compared to direct cash payments. If you have a high-deductible plan or have not yet met your deductible, paying the cash price of $385 upfront may result in lower out-of-pocket costs than the insurance negotiated rate of $388, provided you can secure a prompt-pay discount.
To maximize savings, it is essential to request self-pay or prompt-pay discounts before scheduling your visit, as billing systems often default to insurance processing once a card is on file. Hospitals frequently offer fee reductions of 20% to 50% for upfront payments, which bypasses costly claims processing and administrative labor. Additionally, since over 80% of hospital bills contain errors, you should demand a full itemized CPT-coded bill rather than accepting a summary invoice to identify any unbundled codes or services not rendered. Always verify your specific plan's allowed amount with the hospital prior to check-in to ensure you are aware of your financial responsibility and to avoid unexpected balance billing, especially given that the No Surprises Act protects patients from surprise bills for out-of-network services at in-network facilities.