Colonoscopy with biopsy
Facility: Rehabilitation Hospital Of Overland Park
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $1,189
- Cash Discount Price: $1,586
- vs. Medicare Baseline: 0.97x 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 |
|---|---|---|
| Blue Cross Blue Shield | $951 | 78% |
| Americas Choice Provider Network | $1,110 | 91% |
| Usa Managed Care Organization | $1,189 | 97% |
| Provider Network Of America | $1,189 | 97% |
| Quiktrip Corporation | $1,189 | 97% |
| Velocity | $1,189 | 97% |
| Multiplan-Phcs | $1,268 | 104% |
| Prime Health Services | $1,348 | 110% |
| Medincrease | $1,427 | 117% |
Consumer Guidance & Cost Commentary
For the CPT code 45380, representing a colonoscopy with biopsy, the Rehabilitation Hospital Of Overland Park lists a cash price of $1,586.00. This cash rate is identical to the Medicare benchmark of $1,222.56, indicating no markup above the federal baseline. While commercial insurance negotiates a median rate of $1,189.00 across nine payers, this negotiated amount is still higher than the cash price. For patients with high-deductible plans or those who have already met their deductible, paying the cash price of $1,586.00 may be more cost-effective than relying on insurance, which would result in a higher out-of-pocket expense due to the administrative overhead and contract structures embedded in the negotiated rates.
It is important to note that the facility does not report a specific state or county average for this procedure in the provided data, so direct comparisons to regional pricing are not available. However, patients should be aware that commercial insurance rates often include significant administrative costs and contract markups that can exceed the true cost of care. To potentially lower your bill, you should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can range from 20% to 50% off the listed price for upfront payment. Additionally, if you have insurance, verify your deductible status before scheduling, as using an in-network plan without meeting your deductible could result in paying the full negotiated rate rather than a lower share of the cost.