Colonoscopy (diagnostic)
Facility: Amberwell Atchison Association
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $228
- Cash Discount Price: $761
- vs. Medicare Baseline: 0.24x 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 - $307 | 16% |
| Va Ccn - All Plans | $154 | 16% |
| Superior Select Mcr Adv - All Plans | $154 | 16% |
| Humana | $154 - $206 | 16% |
| Triwest - All Plans | $154 | 16% |
| Centrus Health Direct - All Plans | $184 | 19% |
| Cigna | $204 | 21% |
| Ambetter / Centene | $239 | 25% |
| Oscar - All Plans | $246 | 26% |
| Multiplan - All Plans | $292 | 31% |
| Aetna | $407 | 43% |
| Blue Cross Blue Shield | $408 | 43% |
| Wppa Providrs Care - All Plans | $445 | 47% |
Consumer Guidance & Cost Commentary
For the diagnostic colonoscopy procedure at Amberwell Atchison Association, the cash price is $761.00, which matches the facility's cash median. This rate is significantly lower than the Medicare benchmark of $950.10, reflecting a markup of 0.2 above the federal baseline. While the facility is a Critical Access Hospital in Atchison, KS, and operates as a voluntary non-profit, patients should be aware that commercial insurance negotiated rates vary widely among payers. For instance, UnitedHealthcare and Humana have negotiated ranges starting at $154, whereas Aetna and Blue Cross Blue Shield have negotiated rates of $407 and $408 respectively. Because these negotiated rates often include administrative overhead and claim processing costs, paying cash upfront can sometimes result in a lower out-of-pocket expense compared to the final insurance allowed amount, particularly for those with high-deductible plans.
To maximize savings, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling their visit, as these incentives can reduce the bill by 20% to 50% by bypassing costly insurance billing cycles. It is crucial to sign a waiver of insurance submission to ensure the facility applies the cash rate rather than submitting a claim that may lead to balance billing. Additionally, patients should demand a full itemized bill before paying, as summary invoices often obscure unbundled charges or services not rendered. While the facility's cash rate is competitive, consumers must verify their specific plan's deductible status and compare the facility's negotiated rates against other in-network providers to ensure they are receiving the best possible pricing for their care.