CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Connecticut Childrens Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $3,173
Cash Discount Price: $2,264
vs. Medicare Baseline: 3.34x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Connecticut Childrens Medical Center is $3,173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,264. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 3.34x the Medicare baseline. Located in 282 Washington Street, Hartford, CT.

Cash / Self-Pay

$2,264

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,173

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: $2,264 (238%)

Insurance Median: $3,173 (334%)

Cash: $2,264 (238% of Medicare)

Ins. Median: $3,173 (334% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 334% of the Medicare baseline (a markup of 234%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Harvard Pilgrim [1001134]	$2,752	290%
Multiplan [1001126]	$2,752 - $3,207	290%
UnitedHealthcare	$2,752 - $3,386	290%
Cigna	$2,814	296%
Great West Healthcare [100107]	$2,814	296%
Health Partners [110229]	$2,814	296%
Mvp Health Plan [100144]	$2,814	296%
Tufts Health Plan [100114]	$2,814	296%
Aetna	$2,856 - $3,173	301%
1199 National Benefit Fund [100134]	$3,173	334%
Government Employees Hospital Assoc [100115]	$3,173	334%
Humana	$3,173	334%
Meritain Health [100149]	$3,173	334%
Nippon Life Ins Co Of America [100112]	$3,173	334%
Yale Health Plan [100162]	$3,173	334%
Cdphp/Comm [100199]	$3,207	338%
Generic Multiplan [1001130]	$3,207	338%
Ultrabenefits/Comm [100181]	$3,207	338%
Connecticare [100105]	$3,209 - $3,386	338%
Emblem Health Commercial [1001108]	$3,386	356%
Medicaid / KanCare	$3,386	356%

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 $2,264.
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 Connecticut Childrens Medical Center 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.