CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Boston Medical Center

Billing Code: 45380 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,448

about 1.2× the $1,223 Medicare rate · typically $1,162–$2,255

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,453

About the fair price

about $5 over the fair price · 1.2× Medicare

Medicare pays $1,223 Fair price $1,448 This hospital $1,453 Cash price $1,582 Hospital's list price $3,516

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 $1,453

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

A fair price for a Colonoscopy with biopsy is about $1,448 (about 1.2× the $1,223 Medicare rate). Boston Medical Center charges insurers about $1,453, or about $1,582 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	$695 - $3,415	57%
Blue Cross Blue Shieldmajor	$1,021 - $1,390	84%
Aetnamajor	$1,390 - $1,719	114%
Cignamajor	$1,505 - $2,989	123%
Humanamajor	$1,390	114%
Harvard Pilgrim	$980	80%
Tufts Health Plan	$431 - $1,975	35%
UniCare	$1,021	84%
WellCare	$1,446	118%
+ 20 smaller / regional plans	$513 - $3,415

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 1,582), 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: 45380.

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 45380.
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 with biopsy at other MA hospitals

Metrowest Medical Center · Framingham $395
St Vincent Hospital · Worcester $395
North Adams Regional Hospital Corporation · North Adams $873
Cambridge Health Alliance · Cambridge $1,120
Newton-Wellesley Hospital · Newton $1,120
North Shore Medical Center - · Salem $1,246
Massachusetts General Hospital · Boston $1,246
Brigham and Women's Hospital · Boston $1,246

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