CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Dundy County Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $840
Cash Discount Price: $1,157
vs. Medicare Baseline: 0.88x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Dundy County Hospital is $840. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,157. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.88x the Medicare baseline. Located in P O Box 626, 1313 North Cheyenne St, Benkelman, NE.

Cash / Self-Pay

$1,157

Average discount available for prompt cash payment at this facility.

Insurance Median

$840

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$950.1

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $950.1 (100%)

Cash / Self-Pay: $1,157 (122%)

Insurance Median: $840 (88%)

Cash: $1,157 (122% of Medicare)

Ins. Median: $840 (88% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Molina	$416 - $716	44%
UnitedHealthcare	$416 - $930	44%
Medica	$460 - $791	48%
Blue Cross Blue Shield	$541 - $1,431	57%
Total Care	$546 - $939	57%
Wellcare	$552 - $949	58%
Midlands Choice	$624 - $1,073	66%
Multiplan	$815 - $1,402	86%
Aetna	$1,179 - $2,028	124%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,157.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 45378.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Dundy County Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 45378.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.