CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Brattleboro Memorial Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $545
Cash Discount Price: $615
vs. Medicare Baseline: 0.57x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Brattleboro Memorial Hospital is $545. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $615. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 0.57x the Medicare baseline. Located in 17 Belmont Ave, Brattleboro, VT.

Cash / Self-Pay

$615

Average discount available for prompt cash payment at this facility.

Insurance Median

$545

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: $615 (65%)

Insurance Median: $545 (57%)

Cash: $615 (65% of Medicare)

Ins. Median: $545 (57% 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
Blue Cross Blue Shield	$85 - $1,224	9%
Cigna	$85 - $901	9%
Harvard Pilgrim Health Care	$85 - $875	9%
Martin'S Point	$85 - $875	9%
Mvp Healthcare	$85 - $1,224	9%
New Hampshire Healthy Families (Wellcare)	$90 - $918	9%
Wellsense	$91 - $936	10%
Amerihealth-Caritas	$150 - $705	16%
New Hampshire Healthy Families	$150 - $705	16%
Tufts Health Plan	$416	44%
Vermont Health Plan	$545	57%
Aetna	$770 - $935	81%
Coventry	$770 - $935	81%
Humana	$875	92%
UnitedHealthcare	$875	92%
Multiplan	$1,224	129%

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 $615.
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 Brattleboro 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.