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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
Duluth, MN $284.99 $154.46 – $577.87 116 6
Wyomissing, PA $308.44 $251.00 – $403.58 115 3
Riverside, IL $134.51 $127.80 – $140.66 115 2
Santa Cruz, CA $335.40 $30.93 – $788.73 114 4
Weirton, WV $164.86 $164.86 – $164.86 114 1
Ocean, NJ $76.03 $76.03 – $76.03 113 1
Melbourne, FL $88.63 $76.73 – $117.11 112 2
Wilmington, DE $459.74 $459.74 – $459.74 112 1
Manitowoc, WI $153.01 $143.76 – $217.78 112 2
Fairfield, OH $371.90 $166.68 – $490.40 112 2
Austin, TX $87.57 $73.24 – $124.55 111 2
Mason City, IA $183.98 $153.90 – $273.14 111 2
Bolingbrook, IL $237.91 $222.22 – $240.94 111 2
Macon, GA $205.16 $205.16 – $205.16 110 1
Clermont, FL $112.77 $112.77 – $112.77 108 1
Clearlake, CA $167.07 $79.49 – $310.20 108 2
Lake City, FL $132.35 $59.76 – $198.79 108 3
Cayey, PR $100.31 $100.31 – $100.31 108 1
Kapolei, HI $454.75 $325.73 – $470.88 108 2
Harris, NY $1,406 $1,406 – $1,406 108 1
Hazelwood, MO $187.66 $187.66 – $187.66 107 1
Rochester, NH $641.09 $641.09 – $641.09 107 1
Sugar Land, TX $150.20 $150.20 – $150.20 105 1
Blacksburg, VA $581.15 $581.15 – $581.15 105 1
Springfield, MO $354.11 $352.91 – $363.32 104 2
Kirkland, WA $30.79 $8.55 – $184.78 103 2
Fort Kent, ME $254.59 $254.59 – $254.59 102 1
Goshen, NY $316.54 $258.59 – $381.74 102 2
Trenton, NJ $785.84 $175.17 – $1,025 102 3
Chelsea, MI $500.89 $500.89 – $500.89 102 1
Niskayana, NY $697.79 $697.79 – $697.79 102 1
Daytona Beach, FL $210.15 $82.40 – $232.44 101 2
West New York, NJ $72.29 $45.50 – $102.22 101 3
Harbor City, CA $20.27 $20.27 – $20.27 101 1
Castro Valley, CA $611.34 $611.34 – $611.34 101 1
Scottsbluff, NE $145.69 $145.69 – $145.69 99 1
Ellsworth, ME $559.94 $559.94 – $559.94 98 1
Altoona, PA $177.05 $154.87 – $282.73 98 2
Ruston, LA $184.86 $184.86 – $184.86 98 1
Fort Dodge, IA $278.48 $278.48 – $278.48 97 1
Festus, MO $378.29 $333.98 – $435.27 96 2
East Stroudsburg, PA $257.40 $236.28 – $261.53 93 3
Danville, IN $154.86 $154.86 – $154.86 93 1
Taunton, MA $277.51 $89.02 – $1,435 93 3
Oxford, NC $269.44 $269.44 – $269.44 93 1
Newburyport, MA $114.90 $114.90 – $114.90 93 1
Cypress, TX $801.74 $801.74 – $801.74 93 1
Yuba City, CA $77.85 $0.25 – $220.27 92 3
Kettering, OH $347.01 $347.01 – $347.01 91 1
West Columbia, SC $212.42 $212.42 – $212.42 91 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.