Cost of a Colonoscopy with Biopsy Visit
in Massachusetts
Reviewed by Momentary Medical Group West PC
Massachusetts leads the nation in healthcare coverage with its pioneering universal health insurance model, yet Colonoscopy with Biopsy costs still vary significantly across the state's diverse provider landscape. Based on transparency data from major insurers, patients typically pay between $80 and $2,117 for a Colonoscopy with Biopsy procedure, with a median negotiated rate of $600. With over 1,380 active providers offering these services throughout Massachusetts, patients can browse all specialists across the Bay State to find the most affordable option.
Average
$932
Median
$600
Lowest
$80
Highest
$2,117
Providers
1,381
61% above national average
Compare Similar Procedures
How does colonoscopy with biopsy compare to related procedures in Massachusetts?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $113 | $500 | $1,830 | 1,075 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $735 | $2,338 | 1,352 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $159 | $457 | $1,259 | 1,065 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $80 | $508 | $1,654 | 1,412 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $14 | $80 | 1,987 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $77 | $218 | $677 | 1,520 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $52 | $80 | $328 | 1,764 |
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 Massachusetts
Massachusetts healthcare costs run approximately 20% above the national average, driven by the state's concentration of prestigious academic medical centers and high cost of living. The Commonwealth's compact geography creates intense competition among providers in Greater Boston while leaving some rural areas with limited options.
Urban vs. Rural Provider Availability
The Boston metropolitan area has the highest concentration of gastroenterologists in New England, creating competitive pricing for Colonoscopy with Biopsy procedures. Rural areas like the Berkshires and Cape Cod have fewer specialists, often requiring patients to travel to Springfield or Boston for care. This geographic disparity can significantly impact both cost and access to timely procedures.
Facility Type and Overhead Costs
Hospital-owned practices affiliated with Partners HealthCare (now Mass General Brigham) and other major health systems typically charge 40-60% more than independent gastroenterology groups. Academic medical centers like Mass General and Beth Israel command premium rates due to their research and teaching missions. Community hospitals throughout the state often provide more cost-effective options without sacrificing quality.
Insurance Market Competition in Massachusetts
The state's insurance market is relatively concentrated, with BCBS MA, Tufts Health Plan, and Harvard Pilgrim controlling most of the commercial market. This concentration leads to strong negotiated rates but limited choice for consumers. The Massachusetts Health Connector provides additional options for individual purchasers, creating some pricing competition in specific market segments.
Physician Supply and Demand in Massachusetts
With over 1,380 providers offering Colonoscopy with Biopsy services, Massachusetts has one of the highest per-capita concentrations of gastroenterologists in the nation. This abundant supply helps moderate prices in urban areas but creates referral bottlenecks as primary care physicians have many options. Wait times are generally shorter than the national average, particularly for routine screening procedures.
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 Massachusetts
What is the average cost of a Colonoscopy with Biopsy visit in Massachusetts without insurance?
Does Massachusetts Medicaid cover Colonoscopy with Biopsy visits?
How do I find an affordable Colonoscopy with Biopsy near me in Massachusetts?
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 Massachusetts?
How does telemedicine affect the cost of seeing a Colonoscopy with Biopsy in Massachusetts?
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 |