Colonoscopy (diagnostic)
Facility: Rehabilitation Hospital Of Overland Park
Billing Code: 45378 (CPT)
- CPT Billing Code: 45378
- Insurance Median: $2,830
- Cash Discount Price: $3,773
- vs. Medicare Baseline: 2.98x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 298% of the Medicare baseline (a markup of 198%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 | $2,264 | 238% |
| Americas Choice Provider Network | $2,641 | 278% |
| Provider Network Of America | $2,830 | 298% |
| Velocity | $2,830 | 298% |
| Usa Managed Care Organization | $2,830 | 298% |
| Quiktrip Corporation | $2,830 | 298% |
| Multiplan-Phcs | $3,018 | 318% |
| Prime Health Services | $3,207 | 338% |
| Medincrease | $3,395 | 357% |
Consumer Guidance & Cost Commentary
For the diagnostic colonoscopy procedure at the Rehabilitation Hospital Of Overland Park, the cash price is $3,773.00, which matches the facility's cash median. This rate is significantly higher than the state average, reflecting the specific negotiated and administrative costs associated with this service in Overland Park, KS. While commercial payers have negotiated rates ranging from $2,264 to $3,395, these amounts are generally lower than the cash price, suggesting that paying out-of-pocket might not be the most cost-effective option for those with active insurance coverage. However, patients with high-deductible plans should consider that if their insurance negotiated rate exceeds the cash price, paying cash upfront could result in immediate savings, provided they secure a prompt-pay discount before the claim is submitted.
It is important to distinguish between the facility's gross charge and the amounts paid by insurers, as the latter often includes administrative overhead that inflates the baseline price. The data indicates a median negotiated rate of $2,830.00 across multiple payers, which serves as a benchmark for in-network coverage. Patients should be aware that balance billing is largely prohibited for emergency services and non-emergency care at in-network facilities under federal law, but unexpected charges can still arise from out-of-network ancillary services like lab work or emergency physicians. To avoid these surprises, consumers should request an itemized billing audit to verify that all charges correspond to services rendered and ensure no unbundled codes are being applied. Finally, before scheduling, it is advisable to explicitly ask for self-pay or prompt-pay discounts and sign a waiver of insurance submission to guarantee that the facility processes the account as a cash transaction rather than submitting it to