Colonoscopy with biopsy
Facility: Neosho Memorial Regional Medical Center
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $492
- Cash Discount Price: $419
- vs. Medicare Baseline: 0.40x 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 |
|---|---|---|
| Tricare | $172 | 14% |
| Medicaid / KanCare | $382 | 31% |
| Wppa_Providrscare | $464 | 38% |
| United | $465 | 38% |
| Medadv_Uhc | $492 | 40% |
| Medicare (plans) | $492 | 40% |
| Medadv_Allwell | $492 | 40% |
| Va_Ccn | $492 | 40% |
| Blue Cross Blue Shield | $492 - $559 | 40% |
| Aetna | $492 | 40% |
| Humana | $492 | 40% |
| Ambetter / Centene | $517 | 42% |
| Coventry | $531 | 43% |
| Cigna | $531 | 43% |
| Hpk | $531 | 43% |
Consumer Guidance & Cost Commentary
For a colonoscopy with biopsy at Neosho Memorial Regional Medical Center in Chanute, KS, the facility's negotiated rates range from $172 to $559 depending on your specific insurance plan. While the facility's cash price is $419 and the median amount paid by insurance is $356, these figures are significantly lower than the Medicare benchmark of $1,222.56, which serves as the objective baseline for fair pricing. It is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract structures; therefore, patients with high-deductible plans or those who have not yet met their deductible may find paying the cash price or a prompt-pay discount more financially advantageous than relying on insurance, which could result in higher out-of-pocket costs if the deductible is high.
This facility operates as a Critical Access Hospital with government-local ownership, and its pricing reflects a specific market dynamic where some payers, such as Tricare and Medicaid/KanCare, have fixed rates of $172 and $382 respectively, while others like Blue Cross Blue Shield have a range of $492 to $559. To ensure you receive the most accurate and lowest possible rate, it is recommended to explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling your appointment, as these upfront incentives can reduce the total cost by 20% to 50%. Additionally, if you receive a bill from an out-of-network provider at this in-network facility, you may be eligible for protections under the No Surprises Act, which prevents balance billing for emergency or non-emergency services, so you should review your statement