Wisconsin

Cost of a Colonoscopy Visit
in Wisconsin

Name: Colonoscopy Cost in Wisconsin (2026)
Creator: Jayant Panwar
Published: 2026-03-18

Reviewed by Momentary Medical Group West PC

Wisconsin's healthcare market operates approximately 1% above national cost averages, reflecting the state's balanced mix of urban medical centers and rural clinics across its diverse geography. Colonoscopy patients in Wisconsin typically encounter negotiated rates ranging from $73 to $4,430, with a median cost of $281 based on actual insurer payment data from over 4,400 active providers statewide. Browse all Colonoscopy specialists in Wisconsin to compare costs and find the right provider for your screening or diagnostic needs.

Average

$1,595

Median

$281

Lowest

$73

Highest

$4,430

Providers

4,457

National avg: $517Wisconsin: $1,595

209% above national average

Compare Similar Procedures

How does colonoscopy compare to related procedures in Wisconsin?

Procedure	CPT	Low	Median	High	Providers
Colonoscopy with Biopsy Colonoscopy with biopsy	45380	$73	$385	$5,357	4,222
Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare	45385	$81	$617	$5,357	2,400
Upper Endoscopy (EGD) Diagnostic upper GI endoscopy	43235	$130	$529	$4,430	1,916
Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy	43239	$116	$615	$5,357	2,133
ECG / EKG 12-lead electrocardiogram with interpretation	93000	$19	$73	$102	9,032
Echocardiogram Transthoracic echocardiogram with Doppler	93306	$73	$175	$1,020	5,284
OB Ultrasound Obstetric ultrasound, complete	76805	$68	$95	$502	3,783

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.

Full data methodology and glossary

Why Colonoscopy Visit Costs Vary Across Wisconsin

Wisconsin's healthcare costs run approximately 1% above national averages, reflecting the state's balanced economy and moderate cost of living compared to coastal regions. The state's mix of major metropolitan areas like Milwaukee and Madison alongside extensive rural counties creates distinct pricing tiers across different regions.

Urban vs. Rural Provider Availability

Milwaukee and Madison metro areas concentrate most of Wisconsin's gastroenterology specialists, while rural northern and western counties often require patients to travel significant distances for care. This geographic disparity creates higher costs in underserved areas due to limited competition and travel expenses. Telemedicine consultation options have expanded access but don't replace the need for in-person procedures.

Facility Type and Overhead Costs

Wisconsin's healthcare landscape includes major systems like Froedtert Health, Marshfield Clinic, and UW Health, which operate hospital-based outpatient centers with higher overhead costs. Independent gastroenterology practices typically offer lower facility fees but may have limited hours or services. Academic medical centers in Madison command premium rates due to their teaching hospital status and specialized capabilities.

Insurance Market Competition in Wisconsin

The state's insurance market features moderate competition among Blue Cross Blue Shield of Wisconsin (Anthem), UnitedHealthcare, and regional players like WEA Trust. This competitive environment helps contain negotiated rates compared to more concentrated markets. Rural areas often have fewer insurer options, potentially leading to higher costs due to reduced bargaining power.

Physician Supply and Demand in Wisconsin

With over 4,400 Colonoscopy providers across the state, Wisconsin maintains adequate specialist availability in urban areas but faces shortages in rural regions. This supply imbalance drives up costs and wait times in underserved counties while keeping prices competitive in Milwaukee and Madison. The state's medical schools help maintain steady physician recruitment, though retention in rural areas remains challenging.

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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.

Healthcare Data AnalyticsCMS TiC DataInsurance Price Transparency

Frequently Asked Questions — Colonoscopy Costs in Wisconsin

What is the average cost of a Colonoscopy visit in Wisconsin without insurance?

Uninsured patients in Wisconsin typically pay between $73 and $4,430 for a colonoscopy procedure, with a median cost of $281 based on actual negotiated rates from over 4,400 providers. These prices reflect what insurers pay and may be higher for cash-pay patients, though many providers offer self-pay discounts of 20-40% off standard rates. Shopping around and asking about payment plans can help reduce your out-of-pocket costs significantly.

Does Wisconsin Medicaid cover Colonoscopy visits?

Yes, Wisconsin's expanded Medicaid program covers colonoscopy procedures when medically necessary, including both preventive screenings and diagnostic evaluations. Coverage includes the procedure itself plus related services like anesthesia and pathology when polyps are removed. You'll need to use Medicaid-participating gastroenterologists and facilities, which are widely available in urban areas but may be limited in rural counties.

How do I find an affordable Colonoscopy near me in Wisconsin?

Compare costs across different facility types, as independent gastroenterology practices often charge less than hospital-based outpatient centers. Ask about self-pay discounts if you're uninsured, and consider community health centers which may offer sliding scale fees based on income. Federally Qualified Health Centers throughout Wisconsin provide affordable specialist referrals and may have partnerships with local gastroenterologists for reduced-cost procedures.

What is the difference in cost between an initial consultation and a follow-up visit?

Initial consultations typically cost more than follow-up visits due to the comprehensive evaluation required for new patients. While specific consultation pricing data isn't available for Wisconsin, the colonoscopy procedure itself ranges from $73 to $4,430 with a median of $281. Follow-up visits for discussing results or planning additional care are generally billed at lower rates than the initial procedure.

Can I use an HSA or FSA to pay for a Colonoscopy visit in Wisconsin?

Yes, colonoscopy procedures and related consultations qualify as eligible medical expenses for both Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA). This includes the procedure cost, anesthesia, pathology fees, and any pre-procedure consultations. Using tax-advantaged accounts can effectively reduce your out-of-pocket costs by your marginal tax rate, providing significant savings on this preventive care.

How does telemedicine affect the cost of seeing a Colonoscopy in Wisconsin?

Telemedicine consultations for discussing colonoscopy results or follow-up care typically cost 20-30% less than in-person visits and are widely covered by Wisconsin insurers. However, the colonoscopy procedure itself must be performed in-person at an appropriate facility. Virtual consultations can help reduce overall costs by eliminating travel expenses and allowing for efficient follow-up care, particularly valuable for rural Wisconsin patients who live far from gastroenterology specialists.

Click a state to compare costs

Average Visit Cost

$231