CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Connecticut Childrens Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $4,170
Cash Discount Price: $2,975
vs. Medicare Baseline: 3.41x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Connecticut Childrens Medical Center is $4,170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,975. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 3.41x the Medicare baseline. Located in 282 Washington Street, Hartford, CT.

Cash / Self-Pay

$2,975

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,170

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$1,222.56

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $1,222.56 (100%)

Cash / Self-Pay: $2,975 (243%)

Insurance Median: $4,170 (341%)

Cash: $2,975 (243% of Medicare)

Ins. Median: $4,170 (341% of 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 341% of the Medicare baseline (a markup of 241%). 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]	$3,617	296%
Multiplan [1001126]	$3,617 - $4,214	296%
UnitedHealthcare	$3,617 - $4,449	296%
Cigna	$3,698	302%
Great West Healthcare [100107]	$3,698	302%
Health Partners [110229]	$3,698	302%
Mvp Health Plan [100144]	$3,698	302%
Tufts Health Plan [100114]	$3,698	302%
Aetna	$3,753 - $4,170	307%
1199 National Benefit Fund [100134]	$4,170	341%
Government Employees Hospital Assoc [100115]	$4,170	341%
Humana	$4,170	341%
Meritain Health [100149]	$4,170	341%
Nippon Life Ins Co Of America [100112]	$4,170	341%
Yale Health Plan [100162]	$4,170	341%
Cdphp/Comm [100199]	$4,214	345%
Generic Multiplan [1001130]	$4,214	345%
Ultrabenefits/Comm [100181]	$4,214	345%
Connecticare [100105]	$4,217 - $4,449	345%
Emblem Health Commercial [1001108]	$4,449	364%
Medicaid / KanCare	$4,449	364%
Blue Cross Blue Shield	$6,936	567%
Unicare [100148]	$6,936	567%
Wellpoint [100150]	$6,936	567%

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 $2,975.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 45380.

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 45380.
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.