CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Brattleboro Memorial Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $788
Cash Discount Price: $625
vs. Medicare Baseline: 0.64x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Brattleboro Memorial Hospital is $788. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $625. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.64x the Medicare baseline. Located in 17 Belmont Ave, Brattleboro, VT.

Cash / Self-Pay

$625

Average discount available for prompt cash payment at this facility.

Insurance Median

$788

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: $625 (51%)

Insurance Median: $788 (64%)

Cash: $625 (51% of Medicare)

Ins. Median: $788 (64% 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
Amerihealth-Caritas	$163 - $911	13%
New Hampshire Healthy Families	$163 - $911	13%
Wellsense	$163 - $1,210	13%
Blue Cross Blue Shield	$185 - $1,583	15%
Cigna	$185 - $1,165	15%
Harvard Pilgrim Health Care	$185 - $1,131	15%
Martin'S Point	$185 - $1,131	15%
Mvp Healthcare	$185 - $1,583	15%
New Hampshire Healthy Families (Wellcare)	$194 - $1,188	16%
Tufts Health Plan	$452	37%
Vermont Health Plan	$650	53%
Aetna	$788 - $944	64%
Coventry	$788 - $944	64%
Humana	$1,131	93%
UnitedHealthcare	$1,131	93%
Multiplan	$1,583	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 $625.
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 Brattleboro Memorial Hospital 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.