Cost of a Colonoscopy Visit
in Pennsylvania
Reviewed by Momentary Medical Group West PC
Pennsylvania's healthcare market shows costs approximately 9% above the national average, with concentrated provider networks in Philadelphia and Pittsburgh affecting pricing across the Commonwealth. For Colonoscopy procedures, patients typically see negotiated insurance rates ranging from $85 to $1,830, with a median cost of $323 based on transparency data from over 1,000 active providers statewide. You can browse all Colonoscopy providers in Pennsylvania to compare costs and find the most affordable option for your specific insurance plan.
Average
$746
Median
$323
Lowest
$85
Highest
$1,830
Providers
1,067
44% above national average
Compare Similar Procedures
How does colonoscopy compare to related procedures in Pennsylvania?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $373 | $2,117 | 1,414 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $469 | $2,338 | 1,327 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $90 | $274 | $715 | 1,120 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $80 | $273 | $1,647 | 1,592 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $13 | $55 | $90 | 2,207 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $61 | $155 | $677 | 1,469 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $42 | $85 | $328 | 1,801 |
Important: These are cost estimates only — not a quote and not medical advice.
The prices on this page are self-pay rates, drawn from federal Transparency in Coverage machine-readable files (CPT 45378 — Diagnostic colonoscopy, flexible). They represent what a patient might pay without insurance.
Your actual cost depends on: your specific insurance plan, your remaining deductible, your coinsurance percentage, whether you have met your out-of-pocket maximum, whether the facility and provider are both in-network, and any separate anesthesia or implant fees billed independently.
This page does not constitute medical advice. Whether you need this procedure, and which approach is right for you, is a decision to make with a licensed healthcare provider.
Where this data comes from & what CPT 45378 covers
Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 45378 (Diagnostic colonoscopy, flexible), as mandated by the CMS Price Transparency Rule.
What CPT 45378 covers: the provider's professional fee for colonoscopy. It does not include facility/hospital fees, anesthesia, pre-operative imaging, post-operative care, or any add-on codes billed separately.
How to read this data
Negotiated Rate
The discounted price an insurer has agreed to pay a specific provider. Most insured patients' bills are calculated from this number, not the higher list price hospitals publish separately.
P5, Median, P95
P5 is the rate at the 5th percentile (low end), Median is the middle value, and P95 is the 95th percentile (high end). This range shows how much the same visit can vary between providers.
What this does not tell you
These rates do not tell you what you personally will pay out of pocket. That depends on your specific plan, how much of your deductible you have already met, your coinsurance rate, and whether the provider is in your network. Call your insurer's member line to get your exact estimate.
Why Colonoscopy Visit Costs Vary Across Pennsylvania
Pennsylvania's healthcare costs run approximately 9% above the national average, driven by concentrated urban markets in Philadelphia and Pittsburgh that command premium pricing. The Commonwealth's mix of major academic medical centers and rural critical access hospitals creates significant cost variations for colonoscopy procedures across different regions.
Urban vs. Rural Provider Availability
Pennsylvania's gastroenterology specialists concentrate heavily in the Philadelphia and Pittsburgh metropolitan areas, with limited availability in rural counties of central and northern Pennsylvania. Patients in rural areas often travel 50+ miles for colonoscopy procedures, sometimes requiring overnight stays that add to total costs. The state's Appalachian regions face particular challenges accessing subspecialty care, leading to longer wait times and higher costs when providers are available.
Facility Type and Overhead Costs
Hospital-based outpatient endoscopy centers in Pennsylvania typically charge facility fees 2-3 times higher than independent ambulatory surgery centers for identical colonoscopy procedures. Major health systems like UPMC in Pittsburgh and Penn Medicine in Philadelphia operate high-overhead academic facilities that command premium rates. Freestanding gastroenterology practices often provide the most cost-effective option, particularly for routine screening colonoscopies in healthy patients.
Insurance Market Competition in Pennsylvania
Pennsylvania's insurance market is dominated by Highmark (covering western regions) and Independence Blue Cross Shield (covering southeastern counties), creating regional monopolies that limit rate negotiation leverage. UnitedHealthcare maintains moderate market share statewide, providing some competitive pressure on negotiated rates with providers. The relative lack of insurer competition compared to states like California or Florida contributes to Pennsylvania's above-average healthcare costs.
Physician Supply and Demand in Pennsylvania
With over 1,000 active providers performing colonoscopy procedures, Pennsylvania maintains adequate specialist supply in urban areas but faces shortages in rural counties. The concentration of gastroenterologists in Philadelphia and Pittsburgh creates competitive pricing in those markets while allowing premium rates in underserved regions. Wait times for routine screening colonoscopy average 2-4 weeks in metropolitan areas but can extend to 8-12 weeks in rural Pennsylvania counties.
Jayant Panwar
CEO, Momentary Labs · San Francisco, CA
Jayant has analyzed healthcare pricing data from CMS Transparency in Coverage files since 2022, covering more than 50 million negotiated rate records across all 50 states. His work focuses on making insurer machine-readable files accessible to patients and researchers.
The cost figures on this page reflect his ongoing work to make this data accessible to patients.
Frequently Asked Questions — Colonoscopy Costs in Pennsylvania
What is the average cost of a Colonoscopy visit in Pennsylvania without insurance?
Does Pennsylvania Medicaid cover Colonoscopy visits?
How do I find an affordable Colonoscopy near me in Pennsylvania?
What is the difference in cost between an initial consultation and a follow-up visit?
Can I use an HSA or FSA to pay for a Colonoscopy visit in Pennsylvania?
How does telemedicine affect the cost of seeing a Colonoscopy in Pennsylvania?
Click a state to compare costs
Average Visit Cost
Office visit (CPT 45378)
Compare With Other States
| Rank | State | Average↓ |
|---|---|---|
| 1 | Wisconsin Range: $73 – $4,430 | $1,595 |
| 2 | North Dakota Range: $165 – $2,255 | $1,558 |
| 3 | Minnesota Range: $90 – $2,255 | $1,217 |
| 4 | South Dakota Range: $85 – $2,255 | $895 |
| 5 | Massachusetts Range: $113 – $1,830 | $815 |
| 6 | Rhode Island Range: $91 – $1,830 | $781 |
| 7 | Connecticut Range: $90 – $1,830 | $748 |
| 8 | Delaware Range: $95 – $1,830 | $747 |
| 9 | Pennsylvania Range: $85 – $1,830 | $746 |
| 10 | New York Range: $101 – $1,830 | $743 |
| 11 | West Virginia Range: $85 – $1,395 | $612 |
| 12 | Nebraska Range: $265 – $815 | $594 |
| 13 | New Hampshire Range: $204 – $956 | $571 |
| 14 | Wyoming Range: $158 – $1,057 | $530 |
| 15 | North Carolina Range: $90 – $1,065 | $511 |
| 16 | Georgia Range: $90 – $982 | $507 |
| 17 | New Jersey Range: $110 – $1,117 | $505 |
| 18 | New Mexico Range: $168 – $954 | $502 |
| 19 | Iowa Range: $85 – $944 | $498 |
| 20 | Maine Range: $220 – $674 | $485 |
| 21 | Illinois Range: $85 – $901 | $443 |
| 22 | Utah Range: $85 – $741 | $441 |
| 23 | District of Columbia Range: $126 – $815 | $437 |
| 24 | Indiana Range: $81 – $835 | $425 |
| 25 | Vermont Range: $106 – $801 | $418 |
| 26 | Missouri Range: $174 – $634 | $417 |
| 27 | Washington Range: $80 – $856 | $411 |
| 28 | Oregon Range: $80 – $836 | $408 |
| 29 | Kentucky Range: $85 – $814 | $408 |
| 30 | Maryland Range: $162 – $712 | $396 |
| 31 | Michigan Range: $92 – $768 | $395 |
| 32 | Colorado Range: $85 – $760 | $385 |
| 33 | Hawaii Range: $85 – $757 | $385 |
| 34 | Mississippi Range: $151 – $719 | $381 |
| 35 | Alabama Range: $147 – $649 | $373 |
| 36 | Virginia Range: $124 – $682 | $368 |
| 37 | Louisiana Range: $116 – $670 | $366 |
| 38 | South Carolina Range: $90 – $695 | $363 |
| 39 | Idaho Range: $80 – $735 | $363 |
| 40 | Nevada Range: $204 – $553 | $351 |
| 41 | Arkansas Range: $85 – $634 | $345 |
| 42 | Texas Range: $85 – $634 | $336 |
| 43 | Kansas Range: $174 – $530 | $331 |
| 44 | Ohio Range: $85 – $565 | $325 |
| 45 | Tennessee Range: $90 – $582 | $320 |
| 46 | Oklahoma Range: $85 – $606 | $303 |
| 47 | Arizona Range: $155 – $472 | $300 |
| 48 | California Range: $85 – $647 | $272 |
| 49 | Alaska Range: $80 – $648 | $269 |
| 50 | Montana Range: $80 – $538 | $233 |
| 51 | Florida Range: $35 – $604 | $231 |