CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,648
Cash Discount Price: $1,473
vs. Medicare Baseline: 1.35x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Mary Hitchcock Memorial Hospital is $1,648. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,473. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.35x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.

Cash / Self-Pay

$1,473

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,648

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: $1,473 (120%)

Insurance Median: $1,648 (135%)

Cash: $1,473 (120% of Medicare)

Ins. Median: $1,648 (135% 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
Harvard Pilgrim Health Care Of Ne	$143 - $4,714	12%
UnitedHealthcare	$193 - $8,280	16%
Amerihealth Caritas Nh	$325 - $601	27%
Beacon Health Strategies/Carelon	$325 - $648	27%
Granite State Health Plan	$325 - $668	27%
Wellsense Health Plan	$325 - $1,385	27%
Ambetter / Centene	$459 - $2,839	38%
Cigna	$488 - $4,214	40%
Mass General Brigham Health Plan	$545 - $3,300	45%
Martin'S Point Health Care	$605 - $1,831	49%
Blue Cross Blue Shield	$622 - $5,134	51%
Martin'S Point Generations Advantage	$622 - $1,319	51%
Mvp	$622 - $3,555	51%
Aetna	$640 - $3,725	52%
Wellcare Health Plans	$646 - $1,372	53%
Tufts Health Plan	$694 - $3,096	57%
Maine Community Health Options	$2,752 - $3,900	225%
Coventry	$3,759 - $4,616	307%
First Health/Hcvm	$3,759 - $4,616	307%
Phcs	$3,889 - $4,775	318%
Corvel	$3,975 - $4,882	325%
Ccmsi	$4,105 - $5,041	336%

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 $1,473.
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 Mary Hitchcock Memorial 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.