Colonoscopy with biopsy
Facility: Ascension Via Christi Rehabilitation Hospital Inc
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $983
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.80x 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 |
|---|---|---|
| Aetna | $983 | 80% |
Consumer Guidance & Cost Commentary
For the CPT code 45380, "Colonoscopy with biopsy," the negotiated rate at Ascension Via Christi Rehabilitation Hospital Inc in Wichita, KS is $983. This amount is significantly lower than the Medicare benchmark of $1,222.56, reflecting a standard commercial discount structure where in-network rates typically range between 80% and 100% of the Medicare amount. While the facility does not publish a cash price for this service, patients with high-deductible plans should be aware that paying cash directly can sometimes result in a lower out-of-pocket cost if the insurance negotiated rate exceeds the cash price. It is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid in full upfront.
When reviewing your final invoice, ensure you request a detailed itemized bill rather than accepting a summary statement, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If you receive a large bill after insurance processing, do not pay immediately; instead, dispute any discrepancies in writing to the billing supervisor to avoid unnecessary debt. Additionally, be cautious of balance billing, which occurs when a provider charges you for the difference between their full list price and what your insurance allows. Fortunately, the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, so you have the right to request an audit if you encounter unexpected charges. Always verify your deductible status before scheduling, as paying the negotiated rate may not be necessary if your plan covers the cost.