CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Melrosewakefield Healthcare

Billing Code: 45378 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,094

about 1.2× the $950 Medicare rate · typically $695–$1,781

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,173

About the fair price

about $79 over the fair price · 1.2× Medicare

Medicare pays $950 Fair price $1,094 This hospital $1,173 Cash price $2,525 Hospital's list price $3,607

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 $1,173

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 $1,094 (about 1.2× the $950 Medicare rate). Melrosewakefield Healthcare charges insurers about $1,173, or about $2,525 in cash — about the fair price. Located in Melrose, MA.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$646 - $3,607	68%
Blue Cross Blue Shieldmajor	$284 - $3,607	30%
Aetnamajor	$631 - $2,410	66%
Cignamajor	$902 - $1,942	95%
AmeriHealth	$631 - $1,262	66%
AvMed	$631 - $1,262	66%
GEHA	$631 - $1,262	66%
Harvard Pilgrim	$587 - $2,585	62%
Tufts Health Plan	$673 - $3,607	71%
WellSense	$3,607	380%
+ 108 smaller / regional plans	$322 - $3,607

Government programs also on file: Medicare, Medicaid.

Excludes 12 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 2,525), 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 Melrosewakefield Healthcare 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 Melrosewakefield Healthcare

Compare: Colonoscopy (diagnostic) at other MA hospitals

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