Colonoscopy Cost in Racine, WI (2026): Average Prices & What You'll Pay
What does a colonoscopy cost in Racine, WI?
Where you have a colonoscopy done in Racine, WI swings the bill from $1,562 to $2,068 for identical care. The median cash price across 2 reporting hospitals is $1,815. The numbers are pulled directly from federally mandated hospital price transparency files. The sections below break this down by coverage and by insurer.
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Where colonoscopy costs vary in Racine, WI
Pins show hospitals with price-transparency data (colored by vs. state average) and nearby ambulatory surgery 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 Racine, WI
Based on declared cash/self-pay prices from CMS hospital price transparency files.
| # | Facility | City | Price | vs Median |
|---|---|---|---|---|
| 1 | Lakeview Neurorehab Center Midwest | WI | $2,447 | +$632 |
Prices are declared self-pay rates. Contact each facility for a formal quote before scheduling.
Before you book: three questions that change the price
- Is this the self-pay price, and does it include the doctor, anesthesia and any lab or pathology? Those are often billed separately.
- Can you give me the price in writing, with the billing codes it covers?
- What happens to the price if something extra is needed during the procedure?
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Quick take
- Ask for the cash price if your deductible isn't met - the median cash price here is $1,815, and it's often lower than what insurance pays before your deductible is satisfied.
- This dataset covers hospitals only - freestanding ASCs, which routinely run 30-60% cheaper for the same procedure, aren't included, so it's worth asking your doctor whether one is an option.
How much does a colonoscopy cost with Medicare in Racine, WI?
Medicare's national hospital outpatient payment for colonoscopy is about $950 to $2,352 (typically near $1,223). After the $257 Part B deductible, you generally pay 20% of the Medicare-approved amount, about $245 on a $1,223 payment, with no out-of-pocket cap unless you have supplemental coverage or a Medicare Advantage plan.
Doctor, anesthesia and pathology fees are billed separately. Medicare rates are national CMS amounts, adjusted slightly by local wage levels.
Advocate Aurora Health (formed in the Illinois-Wisconsin merger) and Ascension Wisconsin are the dominant systems in the Milwaukee market, while UW Health anchors the Madison market. Wisconsin's hospital market is moderately competitive in major metros but increasingly concentrated in rural areas. Prices tend to run near or slightly below the Midwest median. Colonoscopy pricing is particularly sensitive to screening vs. diagnostic coding. A screening colonoscopy is typically covered at 100% under preventive care benefits, but if a polyp is removed or a finding is documented during the same visit, the claim is often re-coded as diagnostic - triggering your deductible and coinsurance. Ambulatory surgery centers perform over 70% of colonoscopies nationally and charge substantially less than hospital outpatient settings.
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Why prices vary - and what it means for your coverage
Setting matters too: the median outpatient price is $1,815 versus $2,447 inpatient (about 1.3× more), so where a procedure happens often matters more than which hospital you pick. The biggest swing for this procedure is screening versus diagnostic coding - a polyp removed during a routine screening can recode the whole visit as diagnostic and trigger cost-sharing you weren't expecting.
None of the prices above are what you'll necessarily owe: your deductible, out-of-pocket maximum, and each provider's network status all still apply.
| Your situation | Estimated out-of-pocket |
|---|---|
| Deductible not yet met | ~$1,815 |
| Deductible met - 20% coinsurance | ~$363 |
| Out-of-network provider | $3,993+ |
Frequently asked questions: colonoscopy costs in Racine, WI
How much does a colonoscopy cost in Racine, WI?
The typical price is $1,815, with most facilities between $1,562 and $2,068. Full market pricing - including cash rates, gross charges, and outlier facilities - ranges more widely, from $1,183 to $2,447 across all 2 Racine, WI hospitals that publish prices. 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 Racine, WI?
Based on declared prices, the lowest-cost facility in our Racine, WI data is Aurora Medical Center Burlington in Burlington at about $1,183. Freestanding ambulatory surgery 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 Racine, WI hospitals?
Prices vary up to 2.1× because each hospital sets its own list price, cash discount, and insurer-negotiated rates. In Racine, WI, the median cash (self-pay) price is $1,815 versus a median negotiated rate of $1,326 - about 1.4× higher. Asking for the cash price as well as 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 Racine, WI?
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.
Before you book
- Deductible vs out-of-pocket max
- How to negotiate your medical bills
- EOB vs medical bill: complete guide
- Already have a bill? Check it for errors
- How to read a Medicare Summary Notice
Other procedures in Racine, WI
Colonoscopy, elsewhere
What matters before you schedule
ASC vs. hospital
Hospital outpatient departments typically charge 2-4x more than ambulatory surgery centers for the same colonoscopy - same outcome, very different bill. Call ahead and ask for a self-pay or cash quote at each setting you're considering.
What's on your bill
A colonoscopy involves multiple providers who bill separately - typically Facility Fee, Gastroenterologist Fee, Anesthesia. Check each line item against your Explanation of Benefits to catch billing errors.
Cost by type
Which type your doctor orders for this colonoscopy changes the billing code, and what you pay. For example: Billed as preventive care - often covered at $0 under the ACA when you are average-risk and in-network.
What to ask before you book
Get the CPT code from your doctor, confirm every provider involved (not just the facility) is in-network, ask for the cash-pay rate if you're uninsured or haven't met your deductible, and request a written estimate for colonoscopy before you schedule.
CostKits compiles hospital price transparency data to help families make informed decisions. Track and manage your healthcare costs (free account).
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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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