CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Cambridge Health Alliance

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $949
  • Cash Discount Price: $2,578
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Cambridge Health Alliance is $949. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,578. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.00x the Medicare baseline. Located in 1493 Cambridge Street, Cambridge, MA.
Cash / Self-Pay
$2,578

Average discount available for prompt cash payment at this facility.

Insurance Median
$949

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: $2,578 (271%)
Insurance Median: $949 (100%)
Cash: $2,578 (271% of Medicare)
Ins. Median: $949 (100% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Mass Bh Partnership [70098] $150 16%
Wc [90001] $395 42%
Blue Cross Blue Shield $852 - $1,646 90%
Mass General Brigham [50021] $1,047 110%
Wellpoint [50012] $1,070 113%
Multiplan [50010] $1,119 118%
Other Tufts Health Public Plan [75002] $1,140 120%
Aetna $1,646 173%
Altus Dental [99011] $1,646 173%
Beacon Health Strategies [50002] $1,646 173%
Cbhc Uninsured Crisis Alt Payer [70097] $1,646 173%
Cbhc Uninsured Crisis [70096] $1,646 173%
Celticare [50004] $1,646 173%
Cigna $1,646 173%
Commonwealth Care Alliance Dental [99004] $1,646 173%
Coverage Discovery [90004] $1,646 173%
Delta Dental Of Ma [99007] $1,646 173%
Dominion National Dental [99012] $1,646 173%
Dph Tb Payor [85004] $1,646 173%
Esp Dental [99003] $1,646 173%
Eyemed Alt Payor [13001] $1,646 173%
First Health [50007] $1,646 173%
Global Medical Management [50024] $1,646 173%
Government Employee Health Association [50023] $1,646 173%
Guardian Dental [99013] $1,646 173%
Health Safety Net Dental [99002] $1,646 173%
Humana $1,646 173%
Ma Laborers Health And Welfare Fund [50022] $1,646 173%
Magellan Health Services [65098] $1,646 173%
Mass Health Dental [99001] $1,646 173%
Medical Mutual Of Ohio [50019] $1,646 173%
Medicare (plans) $1,646 173%
Metlife Dental [99008] $1,646 173%
Modern Assistance Program [30098] $1,646 173%
Mva [90002] $1,646 173%
Neighborhood Health Plan [50011] $1,646 173%
Other Bh Payor [50014] $1,646 173%
Other Commercial Payor [50015] $1,646 173%
Other Dental Payor [99014] $1,646 173%
Other Dual Eligible Payer [65004] $1,646 173%
Other Gov'T Alt [85006] $1,646 173%
Other Vision Payor [50013] $1,646 173%
Ri Neighborhood Health Plan [50017] $1,646 173%
Tricare $1,646 173%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1493 Cambridge Street, Cambridge, MA 02139
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals