CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Alice Peck Day Memorial Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,830
Cash Discount Price: $1,345
vs. Medicare Baseline: 1.93x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Alice Peck Day Memorial Hospital is $1,830. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,345. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.93x the Medicare baseline. Located in 10 Alice Peck Day Drive, Lebanon, NH.

Cash / Self-Pay

$1,345

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,830

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: $1,345 (142%)

Insurance Median: $1,830 (193%)

Cash: $1,345 (142% of Medicare)

Ins. Median: $1,830 (193% 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
Ambetter / Centene	$150	16%
Nh Healthy Families	$156	16%
Medicaid / KanCare	$627 - $1,394	66%
Blue Cross Blue Shield	$675 - $2,703	71%
Harvard Pilgrim	$849 - $2,633	89%
UnitedHealthcare	$983 - $2,187	103%
Tufts	$1,001 - $2,227	105%
Cigna	$1,046 - $2,484	110%
Commercial Generic	$1,046 - $2,326	110%
Connecticut General	$1,046 - $2,326	110%
Klais	$1,055 - $2,348	111%
Wellpoint	$1,073 - $2,387	113%
Aetna	$1,228 - $2,733	129%
Mvp	$1,242 - $2,764	131%
Coventry Health	$1,297 - $2,885	137%
Coventry Health Wc	$1,297 - $2,885	137%
Humana	$1,420 - $3,158	149%

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 $1,345.
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 Alice Peck Day 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.