Colonoscopy (diagnostic)
Facility: Children'S Mercy South
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $344
- Cash Discount Price: $392
- vs. Medicare Baseline: 0.36x 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 |
|---|---|---|
| Quiktrip | $82 | 9% |
| Multiplan | $102 | 11% |
| Aetna | $104 - $121 | 11% |
| Blue Cross Blue Shield | $104 - $643 | 11% |
| Healthlink | $114 | 12% |
| Humana | $118 | 12% |
| Orscheln | $119 | 13% |
| Health Midwest Comprehensive Care | $122 | 13% |
| American Healthcare Alliance | $129 | 14% |
| Coventry Health Care Of Kansas | $132 | 14% |
| Wellfit/Centrus | $169 | 18% |
| Centivo | $174 | 18% |
| Nebraska Furniture Mart | $175 | 18% |
| UnitedHealthcare | $320 - $601 | 34% |
| Healthy Blue | $344 - $363 | 36% |
| Medicaid / KanCare | $347 | 37% |
| Home State Health | $363 | 38% |
| Wppa Providrs Care | $411 | 43% |
| Cigna | $444 | 47% |
| Medica | $476 | 50% |
| Mercy Health | $596 | 63% |
| Coxhealth Network | $605 | 64% |
| National Preferred Provider Network | $719 | 76% |
Consumer Guidance & Cost Commentary
For a diagnostic colonoscopy at Children's Mercy South in Overland Park, KS, the facility's cash median price is $392.00, which is significantly lower than the state average for this procedure. While commercial insurance plans like UnitedHealthcare and Cigna negotiate rates ranging from $320 to $605, these in-network amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. The facility offers a voluntary non-profit status and is located at 5808 W 110Th Street, with a Medicare benchmark of $950.10 serving as the objective baseline for evaluating pricing markups.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, it is crucial to verify network status before scheduling. If you choose to pay cash, you may be eligible for a prompt-pay discount by requesting a self-pay classification at registration, which can reduce the bill further. Since over 80% of hospital bills contain errors, always request a full itemized CPT-coded statement before paying, rather than accepting a summary bill that obscures individual charges.