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Based on public Medicaid payment data.

Average Medicaid Colonoscopy Payments

Typical Medicaid Colonoscopy reimbursement across 1,732 cities

Avg. Medicaid Paid

$332.74

Price Range

$0.00 – $2,381

Total Claims

4.1M

Cities

1732

Typical Payment Range

Typical Medicaid Colonoscopy payments fall between $122.78 and $319.24 per claim (median: $190.19). The top 10% of payments exceed $511.60.

Based on per-provider averages across all Medicaid claims in this category.

About This Procedure

A colonoscopy examines the inside of the colon and rectum using a flexible tube with a camera. Used for cancer screening, polyp detection, and investigating digestive symptoms.

Why do these costs look low?

These figures represent Medicaid reimbursement rates β€” the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.

Costs by City

City Avg. Paid Min / Max Claims Providers
Bala Cynwyd, PA $232.82 $232.82 – $232.82 143 1
Fredericksbrg, VA $144.36 $144.36 – $144.36 143 1
Orange Park, FL $172.89 $172.89 – $172.89 142 1
Englewood Cliffs, NJ $204.76 $168.97 – $372.25 142 2
Palm Bay, FL $240.21 $110.54 – $357.62 141 2
West Seneca, NY $401.14 $401.14 – $401.14 141 1
Martinsville, VA $484.85 $484.85 – $484.85 140 1
Muskogee, OK $490.72 $385.41 – $524.50 140 2
Shiprock, NM $218.08 $164.33 – $229.77 140 2
North Dartmouth, MA $86.51 $84.20 – $97.55 139 2
Quincy, IL $186.97 $186.97 – $186.97 139 1
Wisconsin Rapids, WI $189.98 $187.56 – $213.23 138 2
West Des Moines, IA $338.59 $338.59 – $338.59 137 1
Elkin, NC $101.72 $101.72 – $101.72 137 1
Lancaster, SC $61.45 $33.20 – $102.02 134 2
Babylon, NY $172.13 $172.13 – $172.13 134 1
Bardstown, KY $273.72 $273.72 – $273.72 134 1
Mechanicsburg, PA $99.83 $99.83 – $99.83 132 1
St Augustine, FL $141.70 $141.70 – $141.70 131 1
East Brunswick, NJ $190.41 $190.41 – $190.41 131 1
Needham, MA $1,275 $1,275 – $1,275 131 1
Cedar Knolls, NJ $405.00 $405.00 – $405.00 129 1
Manorville, NY $348.05 $348.05 – $348.05 129 1
Laurinburg, NC $207.22 $197.43 – $293.79 128 2
Valley Stream, NY $341.30 $212.57 – $391.67 128 2
Clifton Springs, NY $627.12 $168.67 – $732.92 128 2
Elkhart, IN $744.18 $48.55 – $851.69 127 2
Murrells Inlet, SC $30.46 $0.00 – $122.31 127 3
N Hollywood, CA $0.00 $0.00 – $0.00 127 1
Hillsboro, OR $510.79 $424.27 – $551.03 126 2
Gastonia, NC $367.82 $176.82 – $389.79 126 2
Garfield Heights, OH $605.02 $605.02 – $605.02 126 1
Georgetown, SC $0.00 $0.00 – $0.00 126 1
Cleveland, MS $118.19 $41.56 – $264.24 126 3
Stafford Springs, CT $659.77 $659.77 – $659.77 126 1
Bartonsville, PA $297.95 $297.95 – $297.95 126 1
Woodbridge, VA $509.41 $406.63 – $550.98 125 2
West Plains, MO $363.68 $351.60 – $380.41 124 2
Holmdel, NJ $925.38 $836.67 – $1,105 124 2
Minot, ND $282.80 $282.80 – $282.80 123 1
Round Rock, TX $62.23 $62.23 – $62.23 122 1
Opelousas, LA $208.24 $181.24 – $244.33 122 3
Fishers, IN $646.52 $646.52 – $646.52 122 1
Big Stone Gap, VA $863.18 $863.18 – $863.18 121 1
Bryan, OH $290.56 $236.31 – $304.83 120 2
Summerville, SC $172.66 $169.33 – $194.99 119 3
Millburn, NJ $129.90 $117.72 – $155.84 119 2
Madison, IN $316.06 $316.06 – $316.06 119 1
Bethlehem, PA $279.74 $279.74 – $279.74 118 1
Rockaway Park, NY $229.04 $229.04 – $229.04 117 1

Cost Components

National averages for each billing code in this procedure category. Sorted by claim volume.

Code Description Avg. Paid Claims Providers
45380 Colonoscopy w/biopsy $323.16 2,103,440 4,437
45385 Colonoscopy w/snare removal $355.05 1,176,164 3,169
45378 Colonoscopy diagnostic $334.64 1,008,174 2,650
45384 Colonoscopy w/lesion removal $269.48 41,902 124
45388 Colonoscopy w/ablation $204.19 8,754 32
45382 Colonoscopy w/control bleed $387.88 8,547 9
45381 Colonoscopy w/submucosal inj $184.31 5,092 46
45390 Colonoscopy w/decompression $318.08 2,951 23
45398 Colonoscopy w/resection $388.28 932 6
45379 Colonoscopy w/foreign body β€” β€” β€”
45386 Colonoscopy w/dilation β€” β€” β€”
45389 Colonoscopy w/stent β€” β€” β€”
45391 Colonoscopy w/endoscopic us β€” β€” β€”
45392 Colonoscopy w/us guided inj β€” β€” β€”
45393 Colonoscopy w/decompress volv β€” β€” β€”
45395 Colonoscopy w/band ligation β€” β€” β€”
45397 Colonoscopy w/transanal excis β€” β€” β€”

These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.