Colonoscopy (diagnostic)
Facility: Centura St. Catherine-Dodge City
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $165
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.17x 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 |
|---|---|---|
| Humana | $165 | 17% |
| Aetna | $165 | 17% |
| Medicare (plans) | $165 | 17% |
| Kansas Health | $165 | 17% |
| Kaiser | $165 | 17% |
| Blue Cross Blue Shield | $165 | 17% |
| Cigna | $165 | 17% |
Consumer Guidance & Cost Commentary
For a diagnostic colonoscopy at Centura St. Catherine-Dodge City, the negotiated rate is $165, which matches the lowest and highest amounts reported across seven payers including Humana, Aetna, and Medicare. This rate is significantly lower than the typical commercial markup often seen in healthcare, where negotiated rates can average 200% to 300% of the Medicare benchmark. In this specific case, the Medicare amount for this procedure is $950.10, meaning the negotiated rate represents a substantial discount compared to the federal baseline. Because the negotiated rate is so close to the minimum observed across all plans, patients with high-deductible plans might find that paying cash directly could still be advantageous if the facility offers a self-pay or prompt-pay discount, which can reduce the final bill by 20% to 50%.
It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients should still verify their specific plan details before scheduling. Since the data shows a uniform rate of $165 across all listed payers, there is no variation to exploit, but patients should still request a formal itemized bill to ensure no unbundled charges or services not rendered are included. If a patient receives a summary bill, they should demand a full CPT-coded statement to identify any errors, as over 80% of hospital bills contain mistakes that can be corrected through a written audit dispute. Finally, patients should confirm their deductible status with their insurer before proceeding, as paying the full negotiated rate without meeting the deductible could result in unexpected out-of-pocket costs despite the facility's low listed price.