CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Cheshire Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $2,132
Cash Discount Price: $1,327
vs. Medicare Baseline: 1.74x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Cheshire Medical Center is $2,132. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,327. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.74x the Medicare baseline. Located in 580 Court Street, Keene, NH.

Cash / Self-Pay

$1,327

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,132

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: $1,327 (109%)

Insurance Median: $2,132 (174%)

Cash: $1,327 (109% of Medicare)

Ins. Median: $2,132 (174% 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
Aetna	$199 - $3,629	16%
Amerihealth Caritas Nh	$325 - $649	27%
Granite State Health Plan	$325 - $886	27%
Wellsense Health Plan	$325 - $1,318	27%
Blue Cross Blue Shield	$450 - $4,215	37%
Ambetter / Centene	$524 - $1,095	43%
Cigna	$524 - $4,099	43%
Martin'S Point Generations Advantage	$524 - $1,232	43%
Mvp	$524 - $4,099	43%
UnitedHealthcare	$524 - $4,027	43%
Wellcare Health Plans	$524 - $1,232	43%
Martin'S Point Health Care	$605 - $1,232	49%
Mass General Brigham Health Plan	$823 - $5,306	67%
Tufts Health Plan	$864 - $3,387	71%
Harvard Pilgrim Health Care Of Ne	$917 - $2,644	75%
Maine Community Health Options	$1,938 - $2,388	159%
First Health/Hcvm	$3,661 - $4,510	299%
Phcs	$3,876 - $4,775	317%

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 $1,327.
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 Cheshire Medical Center 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.