Screening Colonoscopy: what it covers and what it costs
What does a Screening Colonoscopy cost? Across 30 major U.S. metros, the typical insurer-negotiated price for a Screening Colonoscopy (HCPCS G0121 / G0105) runs from about $558 in Raleigh, NC to $3,880 in Virginia Beach, VA, read from hospitals' own price-transparency files. 9 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.
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 Screening Colonoscopy price actually covers
A screening colonoscopy is performed for someone at average risk with no symptoms, as colorectal cancer screening. It is a distinct billing category from a diagnostic colonoscopy despite being the same physical procedure.
Code scope. Medicare screening codes: G0121 = average-risk patient; G0105 = high-risk patient (both current). Commercial payers often report screening as CPT 45378 with modifier 33. If a polyp is found during screening it converts to a therapeutic code with modifier PT.
What is — and isn't — in the price
Facility and physician charges are usually separate, with anaesthesia commonly a third. Bowel-preparation medication is dispensed beforehand and paid at a pharmacy, so it sits outside the procedure price entirely.
Why Screening Colonoscopy prices differ so much between hospitals
The distinctive risk here is not between hospitals but between codes. Under federal rules most plans must cover screening colonoscopy without cost-sharing — but if a polyp is found and removed, the procedure can be recoded as diagnostic or therapeutic, and cost-sharing may then apply. Federal rules have narrowed that gap for many plans; it has not vanished for all of them.
What else usually lands on the bill
A stool-based test such as FIT or a multi-target stool DNA test is the cheaper alternative pathway and is billed as a laboratory test. CT colonography is a further alternative with its own imaging code and different coverage rules.
What to ask before you book
Ask specifically how the facility and the physician bill a screening colonoscopy that becomes therapeutic when a polyp is removed, and confirm the anaesthesia provider's billing status separately.
Where the money actually moves
An ambulatory endoscopy centre is materially cheaper than a hospital outpatient department for the same examination. A stool-based test is a far cheaper first-line alternative for average-risk screening, though a positive result leads to a colonoscopy anyway — one that is then coded diagnostic rather than screening.
What the Screening Colonoscopy numbers show nationally
A Screening Colonoscopy costs 7.0× as much in Virginia Beach as in Raleigh
Across the 30 metros priced here, the typical negotiated rate runs from $558 in Raleigh, NC to $3,880 in Virginia Beach, VA — the same billing codes, the same procedure, 595% apart.
The individual hospitals reporting the lowest and highest Screening Colonoscopy prices
Lowest: HARPER UNIVERSITY HOSPITAL (Detroit, MI) at $11; SOUTHWEST GENERAL HEALTH CENTER (Cleveland, OH) at $161; CHILDREN'S HOSPITAL COLORADO (Denver, CO) at $174. Highest: HOAG MEMORIAL HOSPITAL PRESBYTERIAN (Los Angeles, CA) at $7,754; CEDARS-SINAI MEDICAL CENTER (Los Angeles, CA) at $7,331; JEFFERSON STRATFORD HOSPITAL (Philadelphia, PA) at $6,648. These are the figures each hospital published in its own file, not an assessment of the care.
9 of 30 metros have a hospital publishing a self-pay Screening Colonoscopy price
Cheapest published cash price: $239 (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 61% below the list price for a Screening Colonoscopy
Across the 9 metros publishing both, the chargemaster list price is typically 61% above what insurers negotiate. The widest gap is in Cincinnati: $8,206 list against $906 negotiated.
How many hospitals actually publish a Screening Colonoscopy price
190 hospital price-file entries across 30 metros feed this page. A hospital appears only where its own file lists a rate for HCPCS G0121 / G0105 — where it does not, it is absent from the table rather than filled in with a guess.
Screening Colonoscopy price by metro
The typical insurer-negotiated price for a Screening Colonoscopy, by metro — lowest first. 9 of these 30 metros have at least one hospital publishing a self-pay cash price; 9 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 |
|---|---|---|---|---|
| Raleigh, NC | $558 | $558–$888 | — | 3 |
| Detroit, MI | $561 | $11–$808 | $239 | 4 |
| Cincinnati, OH | $906 | $906–$922 | $4,923 | 5 |
| Pittsburgh, PA | $956 | $913–$2,750 | $1,470 | 5 |
| Tampa, FL | $1,020 | $1,007–$1,029 | — | 6 |
| Riverside, CA | $1,152 | $1,108–$1,926 | — | 4 |
| Buffalo, NY | $1,155 | $245–$1,564 | — | 3 |
| Sacramento, CA | $1,158 | $1,158 | $3,220 | 3 |
| San Francisco, CA | $1,158 | $1,158 | $3,220 | 6 |
| Milwaukee, WI | $1,197 | $559–$3,119 | — | 6 |
| Austin, TX | $1,220 | $901–$3,734 | — | 6 |
| Phoenix, AZ | $1,267 | $234–$2,897 | — | 10 |
| Dallas, TX | $1,611 | $283–$5,016 | $2,266 | 10 |
| Miami, FL | $1,639 | $1,154–$5,103 | — | 4 |
| New York, NY | $1,751 | $1,502–$3,578 | $3,675 | 7 |
| Washington, DC | $1,830 | $1,705–$3,790 | — | 6 |
| Seattle, WA | $2,009 | $224–$2,434 | — | 7 |
| Los Angeles, CA | $2,040 | $1,108–$7,754 | — | 5 |
| Nashville, TN | $2,054 | $1,142–$2,070 | — | 9 |
| Birmingham, AL | $2,075 | $1,433–$3,322 | — | 9 |
| Philadelphia, PA | $2,203 | $1,032–$6,648 | $3,241 | 11 |
| Houston, TX | $2,240 | $2,206–$2,246 | — | 6 |
| Portland, OR | $2,976 | $999–$2,976 | — | 7 |
| Hartford, CT | $3,094 | $2,598–$3,237 | — | 4 |
| Kansas City, MO | $3,122 | $504–$3,237 | — | 7 |
| Atlanta, GA | $3,155 | $235–$4,714 | — | 9 |
| Cleveland, OH | $3,265 | $161–$3,810 | $2,371 | 9 |
| Denver, CO | $3,494 | $174–$3,788 | — | 10 |
| Chicago, IL | $3,725 | $3,725 | — | 3 |
| Virginia Beach, VA | $3,880 | $3,461–$3,880 | — | 6 |
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 Screening Colonoscopy cost?
- Across 30 U.S. metros the typical insurer-negotiated price is about $1,830, ranging from $558 in Raleigh to $3,880 in Virginia Beach. Every figure is read from a named hospital's own price-transparency file for HCPCS G0121 / G0105.
- Does the price include the doctor's fee?
- Facility and physician charges are usually separate, with anaesthesia commonly a third. Bowel-preparation medication is dispensed beforehand and paid at a pharmacy, so it sits outside the procedure price entirely.
- Why do Screening Colonoscopy prices differ so much between hospitals?
- The distinctive risk here is not between hospitals but between codes. Under federal rules most plans must cover screening colonoscopy without cost-sharing — but if a polyp is found and removed, the procedure can be recoded as diagnostic or therapeutic, and cost-sharing may then apply. Federal rules have narrowed that gap for many plans; it has not vanished for all of them.