CPT 45378 Surgery - Digestive

How Much Does Colonoscopy (Diagnostic) Cost?

Also known as: Diagnostic colonoscopy (CPT 45378)

A screening colonoscopy for colorectal cancer prevention, covered as a preventive service.

The total estimated cost of Colonoscopy (Diagnostic) (CPT 45378) is $553 to $1,038, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $165.

Total Estimated Cost of Care

$553 — $1,038

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$165
Hospital Facility Fee
$494
Anesthesia (est.)
$33
Important: The physician fee of $165 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$165
Physician component only — CMS PFS 2026
Medicare Physician Fee (Office/Clinic)
$378
Non-facility setting

Patient Guide: Colonoscopy (Diagnostic)

What you need to know before your appointment

What to Expect

Same as a diagnostic colonoscopy: a flexible camera examines your entire colon after sedation. Any polyps found are removed. This is a screening (preventive) procedure.

How Long Does It Take?

30-60 minutes (plus recovery)

Common Reasons Doctors Order This

Routine colon cancer screening starting at age 45, follow-up screening at recommended intervals

How to Prepare

Complete bowel prep as instructed. Arrange a driver. This preventive screening is often covered at no cost-sharing under insurance.

Procedures Commonly Done Together

These procedures are frequently performed alongside Diagnostic colonoscopy

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How to Reduce Your Cost for Diagnostic colonoscopy

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($378) differs from the facility rate ($165). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

3.18
Work RVU
1.34
Practice Expense RVU
0.41
Malpractice RVU
11.32
Total RVU

Payment = Total RVU (11.32) x CF ($33.40) = $378

Frequently Asked Questions

How much does Diagnostic colonoscopy cost?

The Medicare facility rate for Diagnostic colonoscopy is $165. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Diagnostic colonoscopy cost without insurance?

Without insurance, the cost of Diagnostic colonoscopy can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Diagnostic colonoscopy?

Most commercial health insurance plans and Medicare cover Diagnostic colonoscopy when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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