Cost of a Colonoscopy with Biopsy Visit
in Illinois
Reviewed by Momentary Medical Group West PC
Illinois healthcare costs run approximately 10% above the national average, largely driven by the concentrated Chicago metropolitan market and hospital system consolidation. Patients seeking a Colonoscopy with Biopsy in Illinois typically pay between $80 and $1,147, with a median out-of-pocket cost of $441. With nearly 5,000 active Colonoscopy with Biopsy providers throughout the state, patients can browse all available specialists to find quality care that fits their budget.
Average
$556
Median
$441
Lowest
$80
Highest
$1,147
Providers
4,920
4% below national average
Compare Similar Procedures
How does colonoscopy with biopsy compare to related procedures in Illinois?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $85 | $344 | $901 | 4,773 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $220 | $462 | $944 | 5,408 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $118 | $290 | $534 | 3,608 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $70 | $339 | $696 | 5,884 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $17 | $24 | $85 | 10,197 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $74 | $178 | $378 | 6,654 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $45 | $101 | $257 | 6,504 |
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 45380 — Colonoscopy with biopsy). 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 45380 covers
Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 45380 (Colonoscopy with biopsy), as mandated by the CMS Price Transparency Rule.
What CPT 45380 covers: the provider's professional fee for colonoscopy with biopsy. 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 with Biopsy Visit Costs Vary Across Illinois
Illinois healthcare costs run approximately 10% above the national average, reflecting the state's urban concentration around Chicago and the dominance of large health systems like Northwestern Medicine, Rush University Medical Center, and University of Chicago Medicine. The stark divide between the resource-rich Chicago metropolitan area and rural regions creates significant disparities in both access and pricing for specialist care.
Urban vs. Rural Provider Availability
Nearly two-thirds of Illinois gastroenterologists practice in the Chicago metropolitan area, creating longer travel times and higher costs for patients in central and southern Illinois. Rural counties often have no local gastroenterology services, forcing patients to travel to cities like Peoria, Springfield, or Rockford for Colonoscopy with Biopsy procedures. This geographic concentration allows urban providers to command higher rates while rural patients face additional travel and lodging expenses.
Facility Type and Overhead Costs
Hospital-owned practices dominate Illinois's gastroenterology landscape, particularly around Chicago where major academic medical centers have acquired many independent practices. These hospital-employed physicians often charge facility fees in addition to professional fees, significantly increasing total procedure costs. Independent gastroenterology groups remain more common in smaller Illinois cities, typically offering more competitive pricing without facility fee add-ons.
Insurance Market Competition in Illinois
Blue Cross Blue Shield of Illinois holds the largest market share statewide, followed by UnitedHealthcare and Aetna, creating moderate competition that helps control negotiated rates in urban areas. Rural Illinois regions often have limited insurer choices, reducing competitive pressure on provider contracts. The state's Medicaid managed care program covers over 3 million residents through several competing health plans, creating additional negotiating leverage for gastroenterology services.
Physician Supply and Demand in Illinois
With nearly 5,000 active providers performing Colonoscopy with Biopsy procedures, Illinois has adequate specialist supply in aggregate, though geographic distribution heavily favors Chicago and suburban Cook County. This concentration creates competitive pricing in urban markets while allowing rural providers to charge premium rates due to limited local alternatives. Wait times for non-urgent procedures average 2-4 weeks in Chicago but may extend to 6-8 weeks in underserved rural areas.
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 with Biopsy Costs in Illinois
What is the average cost of a Colonoscopy with Biopsy visit in Illinois without insurance?
Does Illinois Medicaid cover Colonoscopy with Biopsy visits?
How do I find an affordable Colonoscopy with Biopsy near me in Illinois?
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 with Biopsy visit in Illinois?
How does telemedicine affect the cost of seeing a Colonoscopy with Biopsy in Illinois?
Click a state to compare costs
Average Visit Cost
Office visit (CPT 45380)
Compare With Other States
| Rank | State | Average↓ |
|---|---|---|
| 1 | Wisconsin Range: $73 – $5,357 | $1,938 |
| 2 | New York Range: $241 – $2,117 | $948 |
| 3 | Massachusetts Range: $80 – $2,117 | $932 |
| 4 | Rhode Island Range: $80 – $2,117 | $910 |
| 5 | Connecticut Range: $85 – $2,117 | $892 |
| 6 | Delaware Range: $80 – $2,117 | $858 |
| 7 | Pennsylvania Range: $80 – $2,117 | $857 |
| 8 | Minnesota Range: $85 – $1,970 | $853 |
| 9 | New Hampshire Range: $433 – $1,234 | $829 |
| 10 | Nebraska Range: $281 – $1,040 | $742 |
| 11 | Iowa Range: $85 – $1,373 | $726 |
| 12 | California Range: $80 – $1,785 | $724 |
| 13 | Maine Range: $456 – $887 | $714 |
| 14 | Wyoming Range: $217 – $1,313 | $657 |
| 15 | Vermont Range: $317 – $1,042 | $632 |
| 16 | Georgia Range: $85 – $1,250 | $620 |
| 17 | New Jersey Range: $120 – $1,329 | $599 |
| 18 | North Carolina Range: $80 – $1,268 | $597 |
| 19 | North Dakota Range: $80 – $1,268 | $594 |
| 20 | District of Columbia Range: $98 – $1,143 | $580 |
| 21 | West Virginia Range: $85 – $1,329 | $574 |
| 22 | New Mexico Range: $90 – $1,136 | $559 |
| 23 | Illinois Range: $80 – $1,147 | $556 |
| 24 | Washington Range: $80 – $1,143 | $536 |
| 25 | Utah Range: $80 – $944 | $520 |
| 26 | Missouri Range: $188 – $815 | $512 |
| 27 | South Dakota Range: $80 – $1,035 | $501 |
| 28 | Maryland Range: $175 – $919 | $489 |
| 29 | Oregon Range: $80 – $1,070 | $486 |
| 30 | Hawaii Range: $80 – $969 | $467 |
| 31 | Colorado Range: $85 – $969 | $466 |
| 32 | Indiana Range: $80 – $937 | $461 |
| 33 | Mississippi Range: $162 – $850 | $454 |
| 34 | Michigan Range: $80 – $887 | $453 |
| 35 | Kentucky Range: $80 – $917 | $439 |
| 36 | Virginia Range: $98 – $830 | $423 |
| 37 | Louisiana Range: $85 – $804 | $422 |
| 38 | Idaho Range: $80 – $906 | $419 |
| 39 | Arkansas Range: $85 – $815 | $416 |
| 40 | Alabama Range: $80 – $762 | $405 |
| 41 | Texas Range: $85 – $772 | $396 |
| 42 | South Carolina Range: $80 – $782 | $389 |
| 43 | Kansas Range: $188 – $646 | $387 |
| 44 | Nevada Range: $85 – $701 | $372 |
| 45 | Ohio Range: $85 – $709 | $371 |
| 46 | Tennessee Range: $85 – $714 | $371 |
| 47 | Alaska Range: $80 – $837 | $332 |
| 48 | Arizona Range: $85 – $567 | $295 |
| 49 | Florida Range: $35 – $770 | $287 |
| 50 | Oklahoma Range: $85 – $582 | $251 |
| 51 | Montana Range: $80 – $545 | $235 |