CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Springfield Hospital

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45378
Insurance Median: $1,732
Cash Discount Price: $1,691
vs. Medicare Baseline: 1.82x Medicare

The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Springfield Hospital is $1,732. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,691. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.82x the Medicare baseline. Located in Po Box 2003, Springfield, VT.

Cash / Self-Pay

$1,691

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,732

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: $1,691 (178%)

Insurance Median: $1,732 (182%)

Cash: $1,691 (178% of Medicare)

Ins. Median: $1,732 (182% 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	$732 - $2,581	77%
Mvp Health Plan	$732 - $1,987	77%
UnitedHealthcare	$732 - $2,323	77%
Wellsense	$732 - $2,581	77%
Harvard Pilgrim Health Care	$739 - $2,136	78%
Wellcare	$754 - $1,010	79%
Tufts Health Plan	$1,184 - $1,586	125%
Cigna	$1,352 - $2,684	142%
Multiplan	$1,599 - $2,142	168%
Aetna	$1,830 - $2,452	193%
Coventry	$1,830 - $2,452	193%
Beacon Health	$1,926 - $2,581	203%
Manage Behavioral Health	$1,926 - $2,581	203%
Martin'S Point Healthcare	$1,926 - $2,581	203%

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 $1,691.
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 Springfield 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.