CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Cheshire Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,584
Cash Discount Price: $1,005
vs. Medicare Baseline: 1.67x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Cheshire Medical Center is $1,584. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,005. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.67x the Medicare baseline. Located in 580 Court Street, Keene, NH.

Cash / Self-Pay

$1,005

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,584

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: $1,005 (106%)

Insurance Median: $1,584 (167%)

Cash: $1,005 (106% of Medicare)

Ins. Median: $1,584 (167% 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
Aetna	$172 - $2,707	18%
Ambetter / Centene	$182 - $847	19%
Blue Cross Blue Shield	$182 - $3,144	19%
Cigna	$182 - $4,099	19%
Martin'S Point Generations Advantage	$182 - $953	19%
Mvp	$182 - $4,099	19%
UnitedHealthcare	$182 - $3,004	19%
Wellcare Health Plans	$182 - $953	19%
Wellsense Health Plan	$182 - $1,019	19%
Amerihealth Caritas Nh	$325 - $484	34%
Granite State Health Plan	$325 - $661	34%
Tufts Health Plan	$493 - $2,526	52%
Mass General Brigham Health Plan	$512 - $3,958	54%
Martin'S Point Health Care	$549 - $953	58%
Harvard Pilgrim Health Care Of Ne	$708 - $2,010	75%
Maine Community Health Options	$1,495 - $1,781	157%
First Health/Hcvm	$2,824 - $3,364	297%
Phcs	$2,990 - $3,562	315%

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 $1,005.
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 Cheshire Medical Center 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.