Colonoscopy with biopsy
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $236
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.19x 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 |
|---|---|---|
| UnitedHealthcare | $225 | 18% |
| Aetna | $234 | 19% |
| Medicaid / KanCare | $234 - $236 | 19% |
| Providrs Care | $551 | 45% |
| Tricare | $691 | 57% |
| Blue Cross Blue Shield | $1,477 - $1,554 | 121% |
Consumer Guidance & Cost Commentary
For the Colonoscopy with biopsy (CPT 45380) at Ascension Via Christi Hospital Manhattan, Inc, the negotiated rates range from $225 to $1,554 depending on your specific insurance plan. While the lowest commercial rates from payers like UnitedHealthcare and Aetna are $225, the median negotiated amount across all plans is $236. This rate is significantly higher than the Medicare benchmark of $1,222.56, which serves as the federal baseline for the true cost of this procedure. In Kansas, where this facility is located, commercial rates often exceed the Medicare benchmark by a wide margin; however, patients should be aware that cash-pay options are not listed for this service, meaning out-of-pocket costs will align with the insurance negotiated rates rather than a lower cash price.
To minimize costs, patients should verify their specific plan's allowed amount before scheduling, as in-network rates can vary widely between carriers. If you have a high-deductible plan where your deductible has not yet been met, you may be responsible for the full negotiated rate of up to $1,554. Since cash prices are not available for this procedure, there is no opportunity to utilize prompt-pay discounts or self-pay reductions that typically lower costs for those paying upfront. We recommend requesting a detailed, itemized bill after your visit to ensure no errors exist, as over 80% of hospital bills contain mistakes that can be corrected. Always confirm with the hospital billing department regarding any potential discounts or payment plans before finalizing your payment.