Colonoscopy Cost in New York, NY (2026): Average Prices & What You'll Pay
What does a colonoscopy cost in New York, NY?
The same colonoscopy in New York, NY might cost you $247 at one facility and $1,367 at another — the building you walk into drives the difference. The median cash price across 117 reporting hospitals is $796. These figures come straight from hospital price transparency files published under federal law.
Where you go inside New York, NY counts as much as which plan you have: Yonkers's median ($1,758) runs 8.5× Bronx's ($206). The same colonoscopy that costs $201 at Newark Beth Israel Medical Center in Newark reaches $4,361 at Westchester Medical Center in Valhalla — a 21.7× gap across the 117 New York, NY hospitals reporting prices. The median New York, NY price is $796. Most facilities fall between $219 and $1,367. Self-pay patients are quoted more than insurers actually pay: the median cash price is $796 versus a median negotiated rate of $162 — about 4.9× higher, so asking for the cash or insurer-negotiated rate is often the single biggest lever on your bill.
Colonoscopy billing is more complex than most procedures — and most patients find out after the fact.
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- ✓ The exact questions to ask before you schedule — that can cut your bill 30–50%
- ✓ What insurance actually covers vs. what they hope you won't notice
- ✓ A real patient billing breakdown, line by line
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Forecast your out-of-pocket cost
- Lower-cost hospitals (bottom 25%): under $219
- Median hospital: $796
- Higher-cost hospitals (top 30%): $1,367+
That's a 6× spread for the same procedure — driven entirely by which facility you choose, not by clinical complexity.
- Patient A (higher-rate plan or out-of-network): ~$1,367
- Patient B (lower-rate in-network plan): ~$247
Where colonoscopy costs vary in New York, NY
Pins show hospitals with price-transparency data (colored by vs. state average) and nearby ambulatory surgery centers, imaging centers, and other facilities (colored by type). Click any pin for facility name and estimated cost range.
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Cheapest Colonoscopy Providers in New York, NY
Based on declared cash/self-pay prices from CMS hospital price transparency files.
| # | Facility | City | Price | vs Median |
|---|---|---|---|---|
| 1 | NYC Health and Hospitals | New York, NY | $206 | -$590 |
| 2 | NYC Health and Hospitals | Brooklyn, NY | $206 | -$590 |
| 3 | Nassau Health Care Corporation | East Meadow, NY | $206 | -$590 |
| 4 | Newark Beth Israel Medical Center | Newark, NY | $206 | -$590 |
| 5 | Robert Wood Johnson University Hospital New Brunswick | New Brunswick, NY | $206 | -$590 |
| 6 | NYC Health and Hospitals | Bronx, NY | $206 | -$590 |
| 7 | NYC Health and Hospitals | Brooklyn, NY | $206 | -$590 |
| 8 | NYC Health and Hospitals | Bronx, NY | $206 | -$590 |
Prices are declared self-pay rates. Contact each facility for a formal quote before scheduling.
The facility you choose matters more than almost anything else — the same procedure, same quality, same state can cost 5× more at one hospital versus the one down the road.
→ Compare all procedure costs → Colonoscopy costs nationwide
Check YOUR hospital's pricing → Estimate YOUR exact cost →
What you'll actually pay — example scenarios
| Your situation | Estimated out-of-pocket |
|---|---|
| Deductible not yet met (pay in full) | ~$796 |
| Deductible met — 20% coinsurance | ~$159 |
| Out-of-network provider | $1,751+ |
Based on the state median facility price of $796. Your actual cost depends on your plan deductible, coinsurance rate, and network tier. Get YOUR personalized estimate →
What this means for you
If you haven't met your deductible, you are effectively a cash-pay patient.
That means:
- You should verify your hospital is in-network before an elective visit when possible
- The cheapest facility can save you $595+ vs. the median.
This is the single biggest lever most patients have to reduce their cost.
Lower-cost options in New York, NY start around $219 or below. Most hospitals cluster between $219 and $1,367. A smaller group reports prices above that — often academic medical centers or high-cost markets.
If you're comparing specific hospitals, the lowest self-pay rates reported in this dataset include: Trinitas Regional Medical Center in Elizabeth (cash price from $201); Clara Maass Medical Center in Belleville (cash price from $201); Montefiore New Rochelle Hospital in New Rochelle (cash price from $201). These are declared cash prices — contact each facility for a formal quote before scheduling.
- Best value hospitals (lowest prices): Trinitas Regional Medical Center: $201; Clara Maass Medical Center: $201; NYC Health and Hospitals: $201
- Most expensive (outpatient): NewYork-Presbyterian Hudson Valley Hospital: ~$4,361; Kindred Hospital East New Jersey: ~$3,840
→ Choosing the right facility can save $595+ vs. the state median.
New York, NY Colonoscopy prices by facility
All prices below come from hospital chargemasters — the official price lists each hospital must publish under federal law. Gross charge is the undiscounted list price; cash price is the self-pay rate; negotiated range covers the spread across insurance contracts.
- Cash price — the self-pay rate you can actually negotiate and pay
- Negotiated rate — if reported by the hospital across insurance contracts
- Gross charge — fallback only; this is the inflated list price few people pay
This reflects the real prices patients encounter — not inflated chargemaster rates.
| # | Facility | City | Your Price | vs Median | Gross Charge |
|---|---|---|---|---|---|
| #1 | Trinitas Regional Medical Center | Elizabeth, NY | $201 | -$595 | $114–$9,159 |
| #2 | Clara Maass Medical Center | Belleville, NY | $201 | -$595 | $149–$7,018 |
| #3 | NYC Health and Hospitals | NY | $201 | -$595 | $104–$9,004 |
| #4 | Montefiore New Rochelle Hospital | New Rochelle, NY | $201 | -$595 | $106–$18,947 |
| #5 | Montefiore Mount Vernon Hospital | Mount Vernon, NY | $201 | -$595 | $104–$18,947 |
| #6 | NYC Health and Hospitals | New York, NY | $202 | -$594 | $104–$9,004 |
| #7 | White Plains Hospital | White Plains, NY | $202 | -$594 | $104–$29,019 |
| #8 | NYC Health and Hospitals | NY | $203 | -$593 | $169–$9,004 |
| #9 | NYC Health and Hospitals | Jamaica, NY | $203 | -$593 | $104–$9,004 |
| #10 | Cooperman Barnabas Medical Center | Livingston, NY | $204 | -$592 | $151–$9,673 |
| #11 | Community Medical Center | Toms River, NY | $204 | -$592 | $154–$9,629 |
| #12 | Nyack Hospital | Nyack, NY | $205 | -$591 | $107–$20,385 |
| #13 | NYC Health and Hospitals | New York, NY | $206 | -$590 | $107–$9,004 |
| #14 | NYC Health and Hospitals | Brooklyn, NY | $206 | -$590 | $107–$9,004 |
| #15 | Nassau Health Care Corporation | East Meadow, NY | $206 | -$590 | $114–$7,653 |
| #16 | Newark Beth Israel Medical Center | Newark, NY | $206 | -$590 | $100–$7,208 |
| #17 | Robert Wood Johnson University Hospital New Brunswick | New Brunswick, NY | $206 | -$590 | $116–$15,197 |
| #18 | NYC Health and Hospitals | Bronx, NY | $206 | -$590 | $107–$9,004 |
| #19 | UPMC Bedford | Everett, NY | $207 | -$589 | $189–$8,733 |
| #20 | BRONXCARE HEALTH SYSTEM | NY | $208 | -$588 | $164–$937 |
| #21 | Robert Wood Johnson University Hospital Somerset | Somerville, NY | $208 | -$588 | $120–$9,867 |
| #22 | Bergen New Bridge | Paramus, NY | $210 | -$586 | $173–$11,356 |
| #23 | Jersey City Medical Center | Jersey City, NY | $211 | -$585 | $110–$8,014 |
| #24 | St. Catherine of Siena Hospital | Smithtown, NY | $219 | -$577 | $140–$2,666 |
| #25 | St. Joseph Hospital | Bethpage, NY | $219 | -$577 | $140–$2,666 |
| #26 | St. Francis Hospital & Heart Center | Roslyn, NY | $219 | -$577 | $140–$2,666 |
| #27 | St. Charles Hospital | Port Jefferson, NY | $219 | -$577 | $140–$2,666 |
| #28 | Mercy Hospital | Rockville Centre, NY | $219 | -$577 | $140–$2,666 |
| #29 | Good Samaritan Hospital | West Islip, NY | $219 | -$577 | $140–$2,666 |
| #30 | Monmouth Medical Center Southern Campus | Lakewood, NY | $220 | -$576 | $194–$9,950 |
| #31 | Maimonides Medical Center | Brooklyn, NY | $225 | -$571 | $128–$7,105 |
| #32 | Robert Wood Johnson University Hospital Rahway | Rahway, NY | $232 | -$564 | $104–$5,532 |
| #33 | The Mount Sinai Hospital | New York, NY | $247 | -$549 | $275–$3,400 |
| #34 | Mount Sinai Queens | Long Island City, NY | $247 | -$549 | $275–$3,400 |
| #35 | Santa Rosa Hospital - Westover Hills | San Antonio, NY | $271 | -$525 | $121–$9,792 |
| #36 | Jamaica Hospital | Flushing, NY | $289 | -$507 | $289–$583 |
| #37 | Monmouth Medical Center | Long Branch, NY | $298 | -$498 | $155–$9,389 |
| #38 | Mount Sinai Brooklyn | Brooklyn, NY | $346 | -$450 | $385–$3,400 |
| #39 | Mount Sinai Behavioral Health Center | New York, NY | $346 | -$450 | $385–$3,400 |
| #40 | Mount Sinai Morningside | New York, NY | $346 | -$450 | $385–$3,400 |
| #41 | NYU Langone | New York, NY | $351 | -$445 | $160–$8,124 |
| #42 | NYU Langone | Mineola, NY | $351 | -$445 | $160–$8,124 |
| #43 | NYU Langone | Brooklyn, NY | $351 | -$445 | $160–$8,124 |
| #44 | CareWell Health Medical Center | East Orange, NY | $368 | -$428 | $186–$15,126 |
| #45 | Putnam Hospital Center | Carmel, NY | $370 | -$426 | $370–$16,368 |
| #46 | EDGERTON HOSPITAL AND HEALTH SERVICES | Edgerton, NY | $383 | -$413 | $525–$769 |
| #47 | Texas Health Huguley Hospital Fort Worth South | Burleson, NY | $403 | -$393 | $153–$2,825 |
| #48 | Saint Clares Hospital | Denville, NY | $415 | -$381 | $1,008–$23,085 |
| #49 | Saint Michaels Medical Center | NY | $415 | -$381 | $2,637–$5,281 |
| #50 | Saint Marys Hospital | NY | $423 | -$373 | $938–$15,390 |
| #51 | Wheaton Franciscan Healthcare - Southeast Wisconsin Inc | NY | $448 | -$348 | $448–$11,874 |
| #52 | St Josephs Hospital - Savannah | Savannah, NY | $477 | -$319 | $477–$1,944 |
| #53 | Tahoe Forest Health System | NY | $604 | -$192 | $604–$949 |
| #54 | Hackensack Meridian Mountainside Medical Center | Montclair, NY | $659 | -$137 | $2,234–$3,764 |
| #55 | ARH Our Lady of the Way Hospital | NY | $664 | -$132 | $1,108–$1,731 |
| #56 | Loma Linda University Childrens Hospital | Loma Linda, NY | $760 | -$36 | $1,690–$4,414 |
| #57 | Bailey Medical Center | Owasso, NY | $784 | -$12 | $2,615–$5,045 |
| #58 | Lovelace Westside Hospital | Albuquerque, NY | $808 | +$12 | $2,694–$8,373 |
| #59 | MUSC Health Florence Medical Center | Florence, NY | $814 | +$18 | $143–$4,794 |
| #60 | Saint Peters University Hospital | NY | $855 | +$59 | $5,700 |
| #61 | Saint Francis Hospital South | Tulsa, NY | $894 | +$98 | $894–$5,838 |
| #62 | Novant Health Huntersville Medical Center | Huntersville, NY | $903 | +$107 | $903–$3,746 |
| #63 | Kingsbrook Jewish Medical Center | NY | $916 | +$120 | $1,744–$3,488 |
| #64 | Brookdale Hospital Medical Center | NY | $916 | +$120 | $1,744–$3,488 |
| #65 | Interfaith Medical Center | NY | $916 | +$120 | $1,744–$3,488 |
| #66 | NewYork-Presbyterian Queens | NY | $964 | +$168 | $964–$1,222 |
| #67 | NewYork-Presbyterian Columbia University Irving Medical Center|NewYork-Presbyterian Weill Cornell Medical Center|NewYork-Presbyterian Brooklyn Methodist Hospital | NY | $968 | +$172 | $968–$1,222 |
| #68 | Maimonides Midwood Community Hospital | Brooklyn, NY | $975 | +$179 | $975 |
| #69 | Parkview Regional Medical Center | Fort Wayne, NY | $983 | +$187 | $983–$21,000 |
| #70 | St Joseph's Hospital, Yonkers | Yonkers, NY | $997 | +$201 | $4,235–$6,300 |
| #71 | Hackensack Meridian at Pascack Valley | Westwood, NY | $1,000 | +$204 | $1,000–$3,831 |
| #72 | Jamaica Hospital Medical Center | Jamaica, NY | $1,000 | +$204 | $1,000–$3,000 |
| #73 | Providence Health and Services - Oregon | Milwaukie, NY | $1,017 | +$221 | $1,017–$8,552 |
| #74 | The Valley Hospital | NY | $1,018 | +$222 | $1,018–$17,843 |
| #75 | Wyckoff Heights Medical Center | Brooklyn, NY | $1,125 | +$329 | $1,125–$9,000 |
| #76 | University Hospital | Newark, NY | $1,195 | +$399 | $1,817–$21,822 |
| #77 | South Shore University Hospital | Bay Shore, NY | $1,367 | +$571 | $2,754–$9,742 |
| #78 | Mather Hospital | Port Jefferson, NY | $1,367 | +$571 | $2,754–$12,281 |
| #79 | Lenox Hill Hospital | New York, NY | $1,367 | +$571 | $2,754–$13,100 |
| #80 | Plainview Hospital | Plainview, NY | $1,367 | +$571 | $2,754–$9,549 |
| #81 | Staten Island University Hospital | Staten Island, NY | $1,367 | +$571 | $2,754–$10,197 |
| #82 | Glen Cove Hospital | Glen Cove, NY | $1,367 | +$571 | $2,754–$9,549 |
| #83 | Huntington Hospital | Huntington, NY | $1,367 | +$571 | $2,754–$9,549 |
| #84 | Peconic Bay Medical Center | Riverhead, NY | $1,367 | +$571 | $2,754–$9,549 |
| #85 | Cohen Children's Medical Center | New Hyde Park, NY | $1,367 | +$571 | $2,754–$11,647 |
| #86 | Syosset Hospital | Syosset, NY | $1,367 | +$571 | $2,754–$9,549 |
| #87 | Phelps Hospital | Sleepy Hollow, NY | $1,367 | +$571 | $2,754–$19,135 |
| #88 | Long Island Jewish Hospital | New Hyde Park, NY | $1,367 | +$571 | $2,754–$11,647 |
| #89 | Long Island Jewish Valley Stream | Valley Stream, NY | $1,367 | +$571 | $2,754–$9,549 |
| #90 | North Shore University Hospital | Manhasset, NY | $1,367 | +$571 | $2,754–$8,711 |
| #91 | Northern Westchester Hospital | Mount Kisco, NY | $1,367 | +$571 | $2,754–$9,549 |
| #92 | Long Island Jewish Forest Hills | Forest Hills, NY | $1,367 | +$571 | $2,754–$8,153 |
| #93 | Wellington Regional Medical Center | Wellington, NY | $1,594 | +$798 | $1,594–$2,342 |
| #94 | Kessler Institute for Rehabilitation, Inc. (West Orange) | West Orange, NY | $1,664 | +$868 | $1,664–$2,382 |
| #95 | Kessler Institute for Rehabilitation, Inc. (North) | Saddle Brook, NY | $1,664 | +$868 | $1,664–$2,382 |
| #96 | Kessler Institute for Rehabilitation, Inc. (Welkind) | Chester, NY | $1,664 | +$868 | $1,664–$2,382 |
| #97 | Good Samaritan Hospital | Suffern, NY | $1,670 | +$874 | $228–$8,244 |
| #98 | Westchester Medical Center | Valhalla, NY | $1,774 | +$978 | $7,891–$76,575 |
| #99 | Mount Sinai South Nassau | Oceanside, NY | $1,820 | +$1,024 | $2,023–$12,464 |
| #100 | Stony Brook University Hospital | Stony Brook, NY | $1,859 | +$1,063 | $1,859–$24,949 |
| #101 | University Hospital of Brooklyn | NY | $1,994 | +$1,198 | $1,994–$37,197 |
| #102 | The Brooklyn Hospital Center | Brooklyn, NY | $2,033 | +$1,237 | $2,033–$19,751 |
| #103 | Memorial Hospital for Cancer and Allied Diseases | NY | $2,118 | +$1,322 | $2,118–$5,714 |
| #104 | The Rehabilitation Hospital at Raritan Bay Medical Center | Westwood, NY | $2,234 | +$1,438 | $2,234 |
| #105 | St. John's Episcopal Hospital | Far Rockaway, NY | $2,289 | +$1,493 | $2,289–$6,867 |
| #106 | Stony Brook Southampton Hospital | Southampton, NY | $2,408 | +$1,612 | $2,408–$18,780 |
| #107 | Stony Brook Eastern Long Island Hospital | Greenport, NY | $2,408 | +$1,612 | $2,408–$8,431 |
| #108 | Select Specialty Hospital - Northeast New Jersey (Rochelle Park Campus) | NY | $2,445 | +$1,649 | $2,445–$2,916 |
| #109 | Tamarack Health Hayward Medical Center | Hayward, NY | $2,460 | +$1,664 | $2,589–$3,298 |
| #110 | St. Barnabas Hospital | Bronx, NY | $2,492 | +$1,696 | $2,492 |
| #111 | St Johns Riverside Hospital - Andrus Pavilion | Yonkers, NY | $2,518 | +$1,722 | $2,963–$3,893 |
| #112 | Kindred Hospital St. Louis South | NY | $2,974 | +$2,178 | $2,974–$3,336 |
| #113 | Hudson Regional Hospital | NY | $3,330 | +$2,534 | $3,330–$8,878 |
| #114 | Kindred Hospital East New Jersey | NY | $3,840 | +$3,044 | $3,840–$4,410 |
| #115 | Kindred Hospital New Jersey - Morris County | Dover, NY | $3,840 | +$3,044 | $3,840–$4,410 |
| #116 | Kindred Hospital New Jersey - Rahway | NY | $3,840 | +$3,044 | $3,840–$4,410 |
| #117 | NewYork-Presbyterian Hudson Valley Hospital | NY | $4,361 | +$3,565 | $1,024–$1,131 |
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Source: CMS hospital price transparency machine-readable files. vs Median = savings or premium relative to the state median price. Gross Charge = undiscounted list price for reference.
Received a bill? Check it for errors → Estimate YOUR cost before you go →
Compare other procedures in New York, NY:
Where you can save the most on colonoscopy in New York, NY
These facilities have the lowest declared prices relative to the state median — they represent the best opportunities to reduce your out-of-pocket cost for this procedure.
| Facility | City | Your Price | vs Median |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth, NY | $201 | -$595 |
| Clara Maass Medical Center | Belleville, NY | $201 | -$595 |
| NYC Health and Hospitals | NY | $201 | -$595 |
| Montefiore New Rochelle Hospital | New Rochelle, NY | $201 | -$595 |
| Montefiore Mount Vernon Hospital | Mount Vernon, NY | $201 | -$595 |
How to choose a lower-cost facility
- Choose independent outpatient centers when possible — freestanding ASCs (ambulatory surgical centers) consistently charge less than hospital outpatient departments for identical procedures.
- Ask for the cash price if your deductible isn't met — self-pay rates are often lower than what insurance pays before your deductible is satisfied, especially at facilities that have a high cash-price discount.
- Avoid hospital outpatient departments for routine cases — hospital-owned locations add a facility fee that freestanding centers don't charge, often adding $500–$1,500 to the same procedure.
Most expensive colonoscopy providers in New York, NY
These facilities report the highest prices for this procedure. Academic medical centers and specialty hospitals often top this list — their gross charges rarely reflect what anyone actually pays, but understanding the spread helps you negotiate.
| Facility | City | Price | vs Median |
|---|---|---|---|
| NewYork-Presbyterian Hudson Valley Hospital | NY | $4,361 | +$3,565 |
| Kindred Hospital East New Jersey | NY | $3,840 | +$3,044 |
| Kindred Hospital New Jersey - Morris County | Dover, NY | $3,840 | +$3,044 |
| Kindred Hospital New Jersey - Rahway | NY | $3,840 | +$3,044 |
| Hudson Regional Hospital | NY | $3,330 | +$2,534 |
Why prices vary this much
A small number of hospitals (5) report very high prices above $3,089, which drives much of the overall price range. Excluding these, most facilities cluster in a significantly tighter band.
Setting drives much of the gap in New York, NY: the median outpatient price is $712 versus $916 inpatient — about 1.3× more, so where a procedure is performed often matters more than which hospital you choose. Of the New York, NY facilities reporting prices, 34 fall in a low-cost tier (up to $219) while 44 sit in a high-cost tier ($1,367 and up) — a lower-priced option almost always exists within the same state.
Among the cities with the most reporting hospitals, Brooklyn has a median reported price of $346 across 9 facilities, while facilities in Bronx tend to report lower prices (median: $206). City-level variation within a state often reflects local market structure, not procedure complexity.
The spread comes from how each hospital sets its chargemaster (the undiscounted list price), what cash discounts it applies, and what rates it negotiates with each insurer. Facility classification matters too — a hospital-owned outpatient center adds a facility fee that a freestanding clinic does not. Understanding these mechanics is the first step to paying less.
Learn more:
→ Allowed amount vs negotiated rate — what your EOB is really saying
→ How to read your medical bill
→ Why hospital prices are so hard to find — and what to do about it
How insurance changes what you actually pay
Hospital list prices are only part of the picture. What you pay out of pocket depends on your deductible, your plan's out-of-pocket maximum, whether the facility is in-network, and whether your plan classifies the visit as outpatient or inpatient. A lower gross charge doesn't guarantee a lower bill if the facility is out-of-network or adds facility fees your plan doesn't cover.
Understand your cost before you go:
→ Deductible vs out-of-pocket max
→ EOB vs medical bill — complete guide
→ How to stop medical bill problems before they start (in-network vs out-of-network)
Compare colonoscopy costs in nearby states
Frequently asked questions: colonoscopy costs in New York, NY
How much does a colonoscopy cost in New York, NY?
Across 117 New York, NY hospitals that publish prices, a colonoscopy ranges from $201 to $4,361, with a median of $796. Most facilities fall between $219 and $1,367. What you pay depends on the facility, your insurance, and whether you have met your deductible.
Where is the cheapest place to get a colonoscopy in New York, NY?
Based on declared prices, the lowest-cost facility in our New York, NY data is Trinitas Regional Medical Center in Elizabeth at about $201. By metro, Bronx has the lowest median ($206). Freestanding ambulatory surgery and imaging centers are often cheaper still and may not appear in hospital price data — ask your doctor whether one is an option.
Why is a colonoscopy so much cheaper at some New York, NY hospitals?
Prices vary up to 21.7× because each hospital sets its own list price, cash discount, and insurer-negotiated rates. In New York, NY, the median cash (self-pay) price is $796 versus a median negotiated rate of $162 — about 4.9× higher. Asking for the cash price or your insurer's negotiated rate is often the single biggest lever on what you pay.
How much will I actually pay out of pocket for a colonoscopy in New York, NY?
Your out-of-pocket cost depends on your deductible, coinsurance, out-of-pocket maximum, and whether the facility is in-network — not just the sticker price. If you have not met your deductible, you will typically pay the negotiated rate in full until you do. Use the CostKits cost forecaster to estimate your specific out-of-pocket amount before you go.
Explore all colonoscopy cost data
→ See colonoscopy costs across all states
Where You Get a Colonoscopy Matters
Hospital outpatient departments typically charge 2–4× more than ASCs or independent centers for the same procedure — same outcome, very different bill.
Hospital Outpatient Department
Hospital Outpatient Department typically carries a higher price for a colonoscopy. Facility fee billed separately from professional fee. Provider-based billing adds facility overhead. You can shop here — call ahead and ask for a self-pay or cash quote.
Ambulatory Surgery Center
Ambulatory Surgery Center typically carries a mid-range price for a colonoscopy. Typically 40–60% less than hospital OP for surgical procedures. Anesthesia billed separately. You can shop here — call ahead and ask for a self-pay or cash quote.
What's Actually on Your Colonoscopy Bill
A colonoscopy involves multiple providers — each bills separately. Understanding each line item helps you verify your Explanation of Benefits and catch billing errors.
Hospital Outpatient
- Facility Fee
- Gastroenterologist Fee
- Anesthesia — Anesthesiologist bills separately. Common source of surprise bills.
- Pathology (if biopsy) (conditional) — CPT 88305 for polyp specimen. Add only for 45380, 45381, 45385 — not for diagnostic 45378.
Asc
- ASC Facility Fee — Medicare ASC rate is ~$510 diagnostic, ~$657 therapeutic — approximately 46% less than OPPS at facility level.
- Gastroenterologist Fee
- Anesthesia
- Pathology (if biopsy) (conditional)
Colonoscopy Cost by Type
Which type your doctor orders changes the billing code — and what you pay. Here's how the common types differ.
Screening Colonoscopy
Billed as preventive care — often covered at $0 under the ACA when you are average-risk and in-network. Diagnostic only — no biopsy or polypectomy. ACA-covered at $0 for average-risk adults 45+.
Diagnostic Colonoscopy
Ordered to investigate symptoms or a prior finding — standard cost-sharing (deductible, coinsurance) applies. Same CPT as screening but billed as diagnostic — cost-sharing applies.
Colonoscopy with Biopsy
Adds a therapeutic step during the procedure, which changes the billing code and can add pathology charges.
Colonoscopy with Polypectomy
Adds a therapeutic step during the procedure, which changes the billing code and can add pathology charges.
Colonoscopy with Submucosal Injection
Adds a therapeutic step during the procedure, which changes the billing code and can add pathology charges.
Covered at $0 — But Only If It Stays a Screening
Under the ACA (§2713), preventive services — including colonoscopy for average-risk adults — must be covered at $0 with no cost-sharing when performed by an in-network provider.
The risk: Screening colonoscopy is covered at $0 under the ACA. If polyps are removed during the same procedure, it converts to a diagnostic colonoscopy and cost-sharing applies.
This Procedure Is Shoppable — Choosing the Right Facility Can Save Thousands
Colonoscopy is elective and schedulable. You have time to compare facilities — and hospital outpatient prices often run 2–4× higher than Hospital OP, ASC for identical clinical outcomes.
How to shop: Ask your doctor for the CPT code, then call 2–3 facilities and request an out-of-pocket cost estimate. Confirm your insurance is accepted. If uninsured, ask for the cash-pay rate — it's usually 20–50% below the list price.
Watch for Separate Bills from These Providers
A colonoscopy involves multiple providers: the facility, the operating physician, and often Anesthesia, Pathology (if biopsy). These providers bill independently — and each one may or may not be in your network, even if the facility is.
Action step: Before your procedure, ask the facility coordinator to confirm that all participating providers are in-network on your plan. The No Surprises Act (2022) protects you from unexpected out-of-network bills in many scenarios — but not all. Request a Good Faith Estimate (GFE) if you ask for one.
Who performs this: Colonoscopy is typically performed by a Gastroenterology or Colorectal Surgery. The specialist's professional fee is billed separately from the facility charge — you will likely receive separate bills from each.
CostKits compiles hospital price transparency data to help families make informed decisions. If you've received a bill for this procedure:
→ Analyze your medical bill for errors
→ How to negotiate your medical bills
→ Track and manage your healthcare costs (free account)
Colonoscopy billing is more complex than most procedures — and most patients find out after the fact.
The free toolkit shows you:
- ✓ Which 3–4 separate bills typically arrive (and which to dispute)
- ✓ Why anesthesia is often billed out-of-network even at in-network facilities
- ✓ The exact questions to ask before you schedule — that can cut your bill 30–50%
- ✓ What insurance actually covers vs. what they hope you won't notice
- ✓ A real patient billing breakdown, line by line
Free for patients — takes 30 seconds to get.
We'll email it to you immediately. No account required, no spam.
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About the Author
John Caruso, FSA, MAAA
Healthcare actuary with 20+ years of experience in insurance pricing, medical billing systems, and healthcare cost analytics.
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