CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Montefiore New Rochelle Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,079
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Montefiore New Rochelle Hospital is $1,079. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.14x the Medicare baseline. Located in 16 Guion Place, New Rochelle, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,079

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%)
Insurance Median: $1,079 (114%)
Ins. Median: $1,079 (114% 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.

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
UnitedHealthcare $188 - $9,691 20%
Healthfirst $643 - $1,079 68%
Molina Healthcare Of Ny Affinity $871 - $1,963 92%
Amidacare $888 - $1,133 93%
Emblem $888 - $15,963 93%
Empire $888 - $6,051 93%
Fidelis $888 - $1,079 93%
Medicaid / KanCare $888 93%
Metroplus $888 - $1,599 93%
Mvp $888 - $1,821 93%
Wellcare $897 - $1,100 94%
Hamaspik $933 - $1,165 98%
Vnsny Choice $1,022 - $1,079 108%
Vnsny Select Health $1,022 108%
Villagecaremax $1,079 114%
Centerlight $1,111 117%
Partners_Health_Plan $1,133 119%
Humana $1,187 125%
Oscar $1,908 - $3,904 201%
Northwell $2,902 305%
Aetna $3,722 392%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 16 Guion Place, New Rochelle, NY 10802
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals