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Sigmoidoscopy with biopsy

CPT 45331 · negotiated-rate distribution across hospitals in MA

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Hospitals
9
Min
$1,017.5
Median
$1,159.58
Max
$1,170.23
Range multiplier
1.2×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield645$52.12$851.82$3,044.158.4×
UnitedHealthcare643$22.71$1,184.72$3,345147.3×
Medicaid434$7.46$47.14$1,436.24192.5×
institution [10406]430$41.9$1,128.3$2,76265.9×
harvard pilgrim [10701]424$492.45$744.89$744.891.5×
Cigna620$705.11$1,589.5$3,563.915.1×
Aetna618$24.88$1,184.72$5,350215.0×
correctional care [11003]316$1,114.51$1,121.41$3,563.913.2×
tufts [11201]411$705.11$2,158.43$2,374.33.4×
tufts connectorcare [10507]49$1,895.77$1,895.77$1,919.241.0×
mgb mcr [10124]49$1,114.51$1,170.23$1,184.721.1×
senior whole health [10110]48$1,192.52$1,199.9$1,207.281.0×
wellpoint [11112]48$627.22$627.22$627.221.0×
tufts us family [11203]48$1,114.51$1,121.41$1,128.31.0×
CHAMPVA48$974.44$1,121.15$1,159.581.2×
hsno/free care [10801]48$294.3$672.16$680.812.3×
fallon mcr [10105]37$1,170.23$1,170.23$1,184.721.0×
commonwealth care mcr [10115]36$1,170.23$1,170.23$1,184.721.0×
grants [20507]46$8.73$1,850$2,762316.4×
Medicare36$1,114.51$1,114.51$1,128.31.0×
tufts dual [10111]36$1,114.51$1,114.51$1,128.31.0×
tufts mcr [10112]25$1,170.23$1,184.72$1,184.721.0×
First Health55$60$2,031$2,071.534.5×
fallon mcr supp [20202]25$1,170.23$1,184.72$1,184.721.0×
hne [11108]44$645.59$1,245.66$1,510.792.3×
fallon mcaid carelon hlth [29]44$992$2,735$2,7622.8×
tufts mcr supp [20209]24$1,170.23$1,170.23$1,170.231.0×
workers compensation [20501]44$483.9$997.46$1,104.82.3×
connecticare [11105]44$992$2,735$2,7622.8×
eternalhealth mcr replace [10116]24$1,170.23$1,170.23$1,170.231.0×
harvard pilgrim mcr supp [20203]24$1,170.23$1,170.23$1,170.231.0×
evernorth behavioral health [27]33$793.6$2,209.6$2,209.62.8×
masshealth mcd mbhp [38]33$992$2,762$2,7622.8×
geisinger13$993.62$1,948.32$2,0502.1×
fallon connectorcare [10503]23$377$713.55$1,947.865.2×
upmc health plan13$89.14$127.34$1,003.1711.3×
pennsylvania health and wellness13$1,000$1,003.17$1,767.491.8×
commonwealth care alliance [10103]13$1,170.23$1,184.72$1,184.721.0×
Multiplan33$2,031$2,071.5$2,071.51.0×
hp optum bh [32]22$992$1,850$2,7082.7×
wellsense cc carelon hlth [20]22$2,762$2,762$2,7621.0×
fallon carelon hlth [28]22$992$1,850$2,7082.7×
harvard pilgrim mcr [10106]12$1,184.72$1,184.72$1,184.721.0×
health partners plans12$1,003.17$1,108.59$1,2141.2×
fidelis care12$25.96$524.42$1,022.8739.4×
Humana22$984.06$1,003.47$1,022.871.0×
keystone first12$974.51$1,158.26$1,3421.4×
masshealth [20302]22$41.9$41.9$41.91.0×
optum transplant [20601]22$2,762$2,762$2,7621.0×
qualcare inc12$87$1,393$2,69931.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
HEALTHALLIANCE-CLINTONLEOMINSTERMA32$6,814.11$6,814.11$27.79$1,170.23$3,290.17
MARLBOROUGH HOSPITALMARLBOROUGHMA37$12,294$12,294$7.46$1,159.58$3,563.91
UMASS MEMORIAL MEDICAL CENTERWORCESTERMA37$12,294$12,294$7.46$1,159.58$3,563.91
HARRINGTON MEMORIAL HOSPITALSOUTHBRIDGEMA31$6,055.27$6,055.27$55.58$1,114.51$1,919.24
BETH ISRAEL DEACONESS - PLYMOUTHPLYMOUTHMA13$4,881$22.71$1,022.87$4,049
CHESTNUT HILL BENEVOLENT ASSOCIATIONCHESTNUT HILLMA19$3,468$89.14$1,017.5$5,350
NORTH ADAMS REGIONAL HOSPITALNORTH ADAMSMA0$2,673.58$2,539.9
FAIRVIEW HOSPITALGREAT BARRINGTONMA0$2,673.58$2,539.9
BERKSHIRE MEDICAL CENTERPITTSFIELDMA0$2,673.58$2,539.9

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.