Diagnostic Colonoscopy: what it covers and what it costs

Endoscopy · outpatient (same-day) · billed as CPT 45378 · priced across 35 metros · 220 hospital price-file entries

What does a Diagnostic Colonoscopy cost? Across 35 major U.S. metros, the typical insurer-negotiated price for a Colonoscopy (CPT 45378) runs from about $258 in Indianapolis, IN to $6,076 in Jacksonville, FL, read from hospitals' own price-transparency files. 11 of those metros have at least one hospital publishing a self-pay cash price. This page explains what the billing code covers, what the quoted price does and does not include, and what actually drives the spread between hospitals. These are price references from public data — not a quote, a bill, or medical or financial advice.

Important — a price reference, not a bill

These figures are aggregated from hospitals' public price-transparency files — not a quote, a bill, an insurance benefit determination, or medical advice. Your actual out-of-pocket cost depends on your insurance plan (deductible, copay, coinsurance, network), the exact service and any complications, and which hospital you use. Always confirm price and coverage with the hospital and your insurer before care.

What a Colonoscopy price actually covers

A diagnostic colonoscopy examines the colon with a flexible camera because of symptoms, a positive stool test, or surveillance after previous findings. The diagnostic designation, rather than screening, is what determines how it is coded.

Code scope. 45378 = diagnostic colonoscopy with no biopsy/intervention. If tissue is removed the code changes (biopsy 45380, snare polypectomy 45385). Screening colonoscopy uses separate G-codes - see screening-colonoscopy entry.

What is — and isn't — in the price

The hospital or endoscopy-centre facility fee covers the room, equipment and recovery. The gastroenterologist's fee is separate, and anaesthesia is generally a third bill. Pathology, if any tissue is taken, is a fourth from the laboratory.

Why Colonoscopy prices differ so much between hospitals

Site of service is decisive: an ambulatory endoscopy centre routinely prices well below a hospital outpatient department for the identical procedure. Anaesthesia practice also varies — monitored anaesthesia care costs more than moderate sedation administered by the endoscopy team.

What else usually lands on the bill

Bowel preparation medication is dispensed and paid separately at a pharmacy. Anaesthesia is billed by its own group. Any tissue removed generates a pathology charge from a laboratory the patient never meets.

What to ask before you book

Ask for the facility fee, the physician fee and the anaesthesia fee separately, and whether the procedure is scheduled at a hospital or an ambulatory endoscopy centre. Those two answers explain most of the final total.

Where the money actually moves

An ambulatory endoscopy centre rather than a hospital outpatient department is the largest single saving, often by a wide margin. Ask separately about the anaesthesia provider — billed by a different group, and a common source of unexpected cost.

What the Colonoscopy numbers show nationally

A Colonoscopy costs 23.6× as much in Jacksonville as in Indianapolis

Across the 35 metros priced here, the typical negotiated rate runs from $258 in Indianapolis, IN to $6,076 in Jacksonville, FL — the same billing codes, the same procedure, 2259% apart.

The individual hospitals reporting the lowest and highest Colonoscopy prices

Lowest: HARPER UNIVERSITY HOSPITAL (Detroit, MI) at $11; SOUTHWEST GENERAL HEALTH CENTER (Cleveland, OH) at $127; CHILDREN'S HOSPITAL COLORADO (Denver, CO) at $174. Highest: CEDARS-SINAI MEDICAL CENTER (Los Angeles, CA) at $18,056; NICKLAUS CHILDREN'S HOSPITAL (Miami, FL) at $8,536; ST VINCENT'S BIRMINGHAM (Birmingham, AL) at $7,135. These are the figures each hospital published in its own file, not an assessment of the care.

11 of 35 metros have a hospital publishing a self-pay Colonoscopy price

Cheapest published cash price: $758 (Detroit). A cash price is what the hospital will accept from someone paying directly; it is not required and many never publish one.

Insurers pay about 57% below the list price for a Colonoscopy

Across the 12 metros publishing both, the chargemaster list price is typically 57% above what insurers negotiate. The widest gap is in Cincinnati: $9,490 list against $906 negotiated.

How many hospitals actually publish a Colonoscopy price

220 hospital price-file entries across 35 metros feed this page. A hospital appears only where its own file lists a rate for CPT 45378 — where it does not, it is absent from the table rather than filled in with a guess.

Colonoscopy price by metro

The typical insurer-negotiated price for a Colonoscopy, by metro — lowest first. 11 of these 35 metros have at least one hospital publishing a self-pay cash price; 12 publish a chargemaster list price. Open a metro for its full hospital-by-hospital breakdown and who those hospitals are.

Metro Typical negotiated Range Cash Hospitals
Indianapolis, IN $258 $258–$555 3
Raleigh, NC $659 $590–$659 3
Cincinnati, OH $906 $906–$940 $5,694 5
Detroit, MI $918 $11–$1,068 $758 6
Pittsburgh, PA $956 $282–$1,000 $1,500 5
Phoenix, AZ $1,008 $1,008–$2,897 10
Tampa, FL $1,029 $1,020–$1,052 6
Riverside, CA $1,108 $295–$3,145 4
Milwaukee, WI $1,128 $903–$3,119 9
Buffalo, NY $1,155 $255–$1,614 3
Sacramento, CA $1,158 $1,045–$1,158 $3,679 4
San Francisco, CA $1,158 $1,158 $3,679 6
Birmingham, AL $1,531 $932–$7,135 8
St. Louis, MO $1,630 $914–$1,850 $2,134 7
Hartford, CT $1,769 $1,518–$3,371 4
Kansas City, MO $1,863 $504–$2,562 7
New York, NY $1,909 $1,802–$3,595 $3,675 7
San Diego, CA $1,994 $562–$4,563 $2,537 6
Washington, DC $2,007 $1,981–$3,486 $1,444 5
Seattle, WA $2,092 $1,471–$2,739 8
Nashville, TN $2,178 $1,535–$2,435 9
Dallas, TX $2,342 $907–$5,016 10
Philadelphia, PA $2,343 $548–$6,648 $3,243 13
Houston, TX $2,433 $2,332–$2,436 6
Miami, FL $2,953 $2,133–$8,536 4
Austin, TX $3,120 $550–$3,734 9
San Jose, CA $3,144 $1,158–$4,408 3
Cleveland, OH $3,205 $127–$4,083 $2,726 9
Portland, OR $3,266 $1,037–$4,130 7
Atlanta, GA $3,295 $291–$4,714 7
Los Angeles, CA $3,380 $1,108–$18,056 5
Denver, CO $3,751 $174–$4,260 10
Chicago, IL $3,780 $3,780 3
Virginia Beach, VA $5,790 $4,564–$5,790 6
Jacksonville, FL $6,076 $6,048–$6,185 3

Source: hospitals' own machine-readable Standard Charges files, published under the U.S. Hospital Price Transparency rule (45 CFR §180.50). Most recent hospital file in this dataset: July 2026. Prices are references, not quotes or bills, and never medical or financial advice — where a hospital reports no price, nothing is shown rather than a guess.

Frequently asked questions

How much does a Colonoscopy cost?
Across 35 U.S. metros the typical insurer-negotiated price is about $1,994, ranging from $258 in Indianapolis to $6,076 in Jacksonville. Every figure is read from a named hospital's own price-transparency file for CPT 45378.
Does the price include the doctor's fee?
The hospital or endoscopy-centre facility fee covers the room, equipment and recovery. The gastroenterologist's fee is separate, and anaesthesia is generally a third bill. Pathology, if any tissue is taken, is a fourth from the laboratory.
Why do Colonoscopy prices differ so much between hospitals?
Site of service is decisive: an ambulatory endoscopy centre routinely prices well below a hospital outpatient department for the identical procedure. Anaesthesia practice also varies — monitored anaesthesia care costs more than moderate sedation administered by the endoscopy team.

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