CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Boston Medical Center

Billing Code: 45378 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,133

about 1.2× the $950 Medicare rate · typically $882–$1,827

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,124

About the fair price

about $9 under the fair price · 1.2× Medicare

Medicare pays $950 Fair price $1,133 This hospital $1,124 Cash price $1,454 Hospital's list price $3,232

How we calculate the fair BaseRate →

How this hospital compares to other MA hospitals

Highest price of the 9 MA hospitals we have prices for — worth calling around.

Cheapest $395 Priciest $1,124

Black dot = this hospital, among the 9 MA hospitals with a price for this procedure. Full list below.

A fair price for a Colonoscopy (diagnostic) is about $1,133 (about 1.2× the $950 Medicare rate). Boston Medical Center charges insurers about $1,124, or about $1,454 in cash — about the fair price. Located in Boston, MA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$745 - $2,654	78%
Blue Cross Blue Shieldmajor	$852 - $1,080	90%
Aetnamajor	$1,080 - $1,845	114%
Cignamajor	$1,505 - $2,747	158%
Humanamajor	$1,080	114%
Harvard Pilgrim	$745	78%
Tufts Health Plan	$431 - $1,535	45%
UniCare	$1,021	107%
WellCare	$1,124	118%
+ 20 smaller / regional plans	$513 - $2,654

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,454), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 45378.

Insurance Before you use insurance

Call your insurance company to confirm Boston Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 45378.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Boston Medical Center

Compare: Colonoscopy (diagnostic) at other MA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.