CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Fairview Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$971

about 0.8× the $1,223 Medicare rate · typically $396–$1,395

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,337

Above the fair price

about $366 over the fair price · 1.1× Medicare

Medicare pays $1,223 Fair price $971 This hospital $1,337 Cash price $3,310 Hospital's list price $3,484

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 $1,337

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 $971 (about 0.8× the $1,223 Medicare rate). Fairview Hospital charges insurers about $1,337, or about $3,310 in cash — above the fair price. Located in Great Barrington, MA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $971. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

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	$498 - $2,996	41%
Blue Cross Blue Shieldmajor	$563 - $2,961	46%
Aetnamajor	$2,630	215%
Cignamajor	$3,135 - $3,240	256%
MVP Health Care	$3,135	256%
UniCare	$867 - $2,259	71%
+ 14 smaller / regional plans	$294 - $3,310

Government programs also on file: Medicare, Medicaid.

Excludes 4 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 3,310), 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 Fairview Hospital 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 Fairview Hospital

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.