Wisconsin

Cost of a Colonoscopy Polyp Removal Visit
in Wisconsin

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

Reviewed by Momentary Medical Group West PC

Wisconsin's healthcare system serves a population where colorectal cancer ranks as the third most common cancer diagnosis, making access to quality Colonoscopy Polyp Removal services particularly important for the state's 5.9 million residents. Patients typically pay between $80.52 and $5,357.06 for these procedures, with a median cost of $616.99 based on negotiated insurance rates across 2,400 active providers statewide. Wisconsin's strong network of gastroenterology specialists spans from urban centers like Milwaukee and Madison to rural communities, allowing patients to browse all providers in Wisconsin to find the most cost-effective care options.

Average

$2,018

Median

$617

Lowest

$81

Highest

$5,357

Providers

2,400

National avg: $752Wisconsin: $2,018

168% above national average

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Always available primary care

Just $19.99/mo

Compare Similar Procedures

How does colonoscopy with polyp removal compare to related procedures in Wisconsin?

Procedure	CPT	Low	Median	High	Providers
Colonoscopy Diagnostic colonoscopy	45378	$73	$281	$4,430	4,457
Colonoscopy with Biopsy Colonoscopy with biopsy	45380	$73	$385	$5,357	4,222
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 45385 — Colonoscopy with removal of polyps by snare). 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 45385 covers

Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 45385 (Colonoscopy with removal of polyps by snare), as mandated by the CMS Price Transparency Rule.

What CPT 45385 covers: the provider's professional fee for colonoscopy with polyp removal. 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 Polyp Removal Visit Costs Vary Across Wisconsin

Wisconsin's healthcare costs run approximately 1% above national averages, reflecting the state's balanced mix of urban medical centers and rural healthcare challenges. The state's geography creates distinct cost patterns, with Milwaukee and Madison commanding premium pricing while northern and western rural counties offer more affordable options.

Urban vs. Rural Provider Availability

Wisconsin's 72 counties show dramatic variation in gastroenterology access, with Milwaukee and Dane counties hosting numerous specialists while northern counties may have only one or two providers within a 50-mile radius. Rural patients often travel to regional centers like Green Bay, La Crosse, or Eau Claire for specialized procedures, creating additional indirect costs. This geographic disparity contributes to price variation as rural providers may charge less to remain competitive despite higher per-case overhead.

Facility Type and Overhead Costs

Wisconsin's major health systems including Froedtert, UW Health, and Advocate Aurora operate extensive networks of hospital-based outpatient facilities with higher overhead costs than independent ambulatory surgery centers. Many gastroenterologists maintain privileges at both hospital systems and freestanding endoscopy centers, giving patients cost options. The state's robust ambulatory surgery center network provides competitive pricing pressure on hospital-based services.

Insurance Market Competition in Wisconsin

Wisconsin maintains moderate insurance market competition with BCBS WI (Anthem) holding significant market share alongside UHC and regional players like WEA Trust serving educators. This competitive environment has resulted in well-negotiated provider rates, though consolidation among health systems has increased their bargaining power. Rural counties often have fewer insurer options, potentially limiting competitive pressure on pricing.

Physician Supply and Demand in Wisconsin

With 2,400 active providers performing colonoscopy procedures across Wisconsin, the state maintains adequate specialist availability relative to its population, though distribution favors urban areas. This robust supply helps moderate pricing in competitive markets like Milwaukee and Madison. Wait times for routine screening procedures typically range from 2-6 weeks, indicating balanced supply and demand that supports stable pricing.

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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 Polyp Removal Costs in Wisconsin

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

Without insurance, colonoscopy with polyp removal in Wisconsin typically costs between $80.52 and $5,357.06, with a median price of $616.99 based on negotiated insurance rates. Self-pay patients often receive discounts of 30-50% off these standard rates when paying in cash. Many Wisconsin facilities offer payment plans to help manage these costs, and ambulatory surgery centers tend to charge less than hospital outpatient departments.

Does Wisconsin Medicaid cover Colonoscopy Polyp Removal visits?

Yes, Wisconsin Medicaid covers colonoscopy and polyp removal procedures when medically necessary or for routine screening. As a Medicaid expansion state, Wisconsin provides this coverage to eligible adults, including those newly eligible under expanded income guidelines. Prior authorization may be required for certain cases, and patients should verify their provider accepts Medicaid before scheduling.

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

Compare costs between hospital outpatient departments and ambulatory surgery centers, as the latter often charge significantly less for the same procedure. Ask about self-pay discounts if you're uninsured, and consider community health centers that offer sliding fee scales based on income. Rural Wisconsin facilities may offer lower prices than urban centers, though you'll need to factor in travel costs.

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

Initial gastroenterology consultations typically cost more than follow-up visits due to the comprehensive evaluation required. The actual colonoscopy with polyp removal procedure costs between $80.52 and $5,357.06 regardless of whether it's your first or subsequent procedure. However, the pre-procedure consultation and post-procedure follow-up visits are billed separately and may vary based on complexity.

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

Yes, colonoscopy with polyp removal qualifies as an eligible medical expense for both Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA). This includes the procedure itself, related consultations, pathology costs for polyp analysis, and any necessary medications. Keep all receipts and documentation for reimbursement or tax purposes when using these pre-tax healthcare dollars.

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

While the actual colonoscopy procedure must be performed in-person, initial consultations and follow-up visits can often be conducted via telemedicine in Wisconsin, typically costing $50-150 less than in-person visits. Many Wisconsin gastroenterologists expanded telehealth services during the pandemic and continue offering virtual consultations for appropriate cases. Insurance coverage for telehealth visits varies by plan, so verify benefits before scheduling virtual appointments.

Click a state to compare costs

Average Visit Cost

$272