CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Signature Healthcare Brockton Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,743
Cash Discount Price: $1,786
vs. Medicare Baseline: 1.43x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Signature Healthcare Brockton Hospital is $1,743. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,786. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.43x the Medicare baseline. Located in 680 Center Street, Brockton, MA.

Cash / Self-Pay

$1,786

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,743

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: $1,786 (146%)

Insurance Median: $1,743 (143%)

Cash: $1,786 (146% of Medicare)

Ins. Median: $1,743 (143% 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.

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
Commonwealth Care Alliance	$944	77%
Fallon	$1,372 - $1,715	112%
Humana	$1,400	115%
Tufts Health Plan	$1,400	115%
Allways Health Partners	$1,428	117%
Senior Whole Health	$1,708	140%
Blue Cross Blue Shield	$1,743	143%
Unicare	$1,860	152%
Cigna	$1,942	159%
Aetna	$2,119 - $3,399	173%
Harvard Pilgrim Healthcare	$2,332	191%
UnitedHealthcare	$3,672	300%

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 $1,786.
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 Signature Healthcare Brockton Hospital 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.