CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,263
Cash Discount Price: $1,148
vs. Medicare Baseline: 1.33x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Mary Hitchcock Memorial Hospital is $1,263. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,148. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.33x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.

Cash / Self-Pay

$1,148

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,263

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$950.1

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $950.1 (100%)

Cash / Self-Pay: $1,148 (121%)

Insurance Median: $1,263 (133%)

Cash: $1,148 (121% of Medicare)

Ins. Median: $1,263 (133% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $950.1 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
Harvard Pilgrim Health Care Of Ne	$132 - $3,584	14%
Blue Cross Blue Shield	$167 - $3,970	18%
Martin'S Point Generations Advantage	$167 - $1,020	18%
Mvp	$167 - $2,801	18%
UnitedHealthcare	$167 - $8,280	18%
Aetna	$172 - $2,935	18%
Cigna	$172 - $4,214	18%
Wellsense Health Plan	$172 - $1,071	18%
Wellcare Health Plans	$173 - $1,061	18%
Ambetter / Centene	$175 - $2,195	18%
Amerihealth Caritas Nh	$325 - $474	34%
Beacon Health Strategies/Carelon	$325 - $510	34%
Granite State Health Plan	$325 - $526	34%
Martin'S Point Health Care	$439 - $1,442	46%
Mass General Brigham Health Plan	$532 - $2,601	56%
Tufts Health Plan	$632 - $2,439	67%
Maine Community Health Options	$2,116 - $3,073	223%
Coventry	$2,890 - $3,637	304%
First Health/Hcvm	$2,890 - $3,637	304%
Phcs	$2,990 - $3,763	315%
Corvel	$3,056 - $3,847	322%
Ccmsi	$3,156 - $3,972	332%

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 $1,148.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 45378.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mary Hitchcock Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 45378.
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.