CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Boston Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,080
  • Cash Discount Price: $1,454
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Boston Medical Center is $1,080. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,454. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.14x the Medicare baseline. Located in 1 Boston Medical Center Place, Boston, MA.
Cash / Self-Pay
$1,454

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,080

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: $1,454 (153%)
Insurance Median: $1,080 (114%)
Cash: $1,454 (153% of Medicare)
Ins. Median: $1,080 (114% 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
Workers Comp [5002] $395 42%
Zzzbu Employee Work Comp [5004] $395 42%
Zzzcity Of Boston Work Comp [5003] $395 42%
Tufts Conncare/Qhp [8020] $431 - $1,535 45%
Hsn Bad Debt [4003] $513 54%
Hsn Confidential [4007] $513 54%
Hsn Dental [4006] $513 54%
Hsn Partial [4002] $513 54%
Hsn [4001] $513 54%
Tufts [8002] $736 - $1,505 77%
Harvard Pilgrim Health Care [8001] $745 78%
Health Plans Inc [2027] $745 78%
United [2025] $745 - $2,654 78%
Zzzhealth Plans Inc [1013] $745 78%
Zzzunited [1008] $745 - $2,654 78%
Blue Cross Blue Shield $852 - $1,080 90%
Unicare [8004] $1,021 107%
Wellpoint [2034] $1,021 107%
Champva [9004] $1,029 108%
Tricare $1,029 108%
Aetna $1,080 - $1,845 114%
Humana $1,080 114%
Medicare (plans) $1,080 - $1,134 114%
Neighborhood Pace [1206] $1,080 114%
Ubh Hphc [8016] $1,080 114%
UnitedHealthcare $1,080 - $2,654 114%
Veterans Admin [9003] $1,080 114%
Zzzcovid19 Hrsa Uninsured Testing And Treatment Fund [500010] $1,080 114%
Wellcare [1240] $1,124 118%
Cca [1215] $1,134 119%
Corrections [9001] $1,134 - $1,350 119%
Zzzcca Onecare [1216] $1,134 119%
Eternalhealth [1227] $1,145 121%
Medicaid / KanCare $1,164 123%
Fallon Sco [1126] $1,188 125%
Uphams Corner Esp [1213] $1,293 136%
Senior Whole Health [1210] $1,296 136%
Fallon [8008] $1,404 148%
Cigna $1,505 - $2,747 158%
Mass General Brigham Health Plan Commercial [8009] $1,743 183%
Meritain Health [1023] $1,845 194%
Oxford Health [1007] $2,654 279%
Oxford Health [2024] $2,654 279%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Boston Medical Center Place, Boston, MA 02118
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals