CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Montefiore New Rochelle Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,395
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Montefiore New Rochelle Hospital is $1,395. 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 $1,222.56, 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
$1,395

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%)
Insurance Median: $1,395 (114%)
Ins. Median: $1,395 (114% 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.

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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 $204 - $9,691 17%
Healthfirst $643 - $1,395 53%
Molina Healthcare Of Ny Affinity $871 - $1,963 71%
Amidacare $888 - $1,465 73%
Emblem $888 - $15,963 73%
Empire $888 - $9,074 73%
Fidelis $888 - $1,395 73%
Medicaid / KanCare $888 73%
Metroplus $888 - $1,814 73%
Mvp $888 - $1,821 73%
Wellcare $897 - $1,423 73%
Hamaspik $933 - $1,507 76%
Vnsny Choice $1,022 - $1,395 84%
Vnsny Select Health $1,022 84%
Villagecaremax $1,395 114%
Centerlight $1,437 118%
Partners_Health_Plan $1,465 120%
Humana $1,535 126%
Oscar $1,908 - $3,904 156%
Aetna $3,722 304%
Northwell $3,753 307%

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