Cost of a Colonoscopy with Biopsy Visit
in Kentucky
Reviewed by Momentary Medical Group West PC
Kentucky's rural healthcare landscape creates significant cost variations for specialty services, with many patients traveling to Louisville or Lexington for procedures. Colonoscopy with Biopsy procedures in Kentucky typically range from $80 to $917, with most patients paying around $322 based on negotiated insurance rates. The state's 270 active providers offer patients multiple options for accessing gastroenterology services across both urban medical centers and regional clinics.
Average
$439
Median
$322
Lowest
$80
Highest
$917
Providers
270
24% below national average
Compare Similar Procedures
How does colonoscopy with biopsy compare to related procedures in Kentucky?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $85 | $324 | $814 | 243 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $202 | $421 | $1,136 | 210 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $106 | $249 | $631 | 191 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $60 | $220 | $830 | 282 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $80 | $88 | 945 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $64 | $152 | $477 | 283 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $44 | $92 | $229 | 248 |
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 Kentucky
Kentucky's healthcare costs run approximately 5% below national averages, reflecting the state's lower cost of living and rural provider economics. The concentration of major medical centers in Louisville and Lexington creates pricing disparities with smaller regional markets across the commonwealth.
Urban vs. Rural Provider Availability
Kentucky's 270 Colonoscopy with Biopsy providers are heavily concentrated in the Louisville and Lexington metropolitan areas, creating access challenges for residents of eastern and western Kentucky. Rural patients often travel 1-2 hours for specialty gastroenterology services, with some providers offering satellite clinics in smaller communities. This geographic imbalance allows urban providers to maintain higher procedure volumes while rural referral patterns concentrate patients at regional medical centers.
Facility Type and Overhead Costs
Hospital-based outpatient departments at major Kentucky health systems like Norton Healthcare, Baptist Health, and UK HealthCare typically charge facility fees that independent gastroenterology practices do not. Academic medical centers in Louisville and Lexington often have higher overhead costs due to teaching and research missions. Ambulatory surgery centers specializing in endoscopy procedures may offer more competitive pricing than hospital-based facilities.
Insurance Market Competition in Kentucky
Kentucky's moderate insurance market concentration among Anthem, UHC, and Humana creates sufficient competition to keep negotiated rates reasonable compared to more consolidated markets. The state's Medicaid managed care contracts with multiple insurers provide additional competitive pressure on provider reimbursement rates. However, rural areas may have fewer insurer options, potentially limiting provider network choices for some patients.
Physician Supply and Demand in Kentucky
With 270 active providers performing Colonoscopy with Biopsy procedures statewide, Kentucky maintains adequate specialist coverage for its population, though geographic distribution favors urban areas. This supply concentration allows established practices in Louisville and Lexington to maintain steady patient volumes without aggressive price competition. Rural referral patterns and limited specialist availability in outlying areas can create longer wait times but may also result in more competitive pricing at regional centers seeking to attract patients from metropolitan markets.
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 Kentucky
What is the average cost of a Colonoscopy with Biopsy visit in Kentucky without insurance?
Does Kentucky Medicaid cover Colonoscopy with Biopsy visits?
How do I find an affordable Colonoscopy with Biopsy near me in Kentucky?
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 Kentucky?
How does telemedicine affect the cost of seeing a Colonoscopy with Biopsy in Kentucky?
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 |