Cost of a Colonoscopy with Biopsy Visit
in New York
Reviewed by Momentary Medical Group West PC
New York's healthcare market operates at costs roughly 22% above the national average, reflecting the state's high concentration of academic medical centers and specialist providers. Colonoscopy with Biopsy patients typically pay between $240 and $2,117, with a median out-of-pocket cost of $488 based on negotiated insurance rates. New York maintains over 31,000 active providers performing these procedures, giving patients substantial choice when browsing all gastroenterology specialists across the state.
Average
$948
Median
$488
Lowest
$241
Highest
$2,117
Providers
31,059
64% above national average
Compare Similar Procedures
How does colonoscopy with biopsy compare to related procedures in New York?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $101 | $298 | $1,830 | 30,995 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $276 | $507 | $2,338 | 30,991 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $159 | $274 | $771 | 30,910 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $166 | $417 | $1,647 | 31,089 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $10 | $16 | $63 | 32,178 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $51 | $171 | $895 | 31,068 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $36 | $112 | $328 | 31,848 |
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 New York
New York's healthcare costs run approximately 22% above national averages, driven by high real estate costs, stringent state regulations, and concentration of prestigious medical institutions. The state's complex geography creates dramatic cost variations between Manhattan's premium medical centers and rural upstate facilities serving smaller populations.
Urban vs. Rural Provider Availability
The New York City metropolitan area concentrates most gastroenterology specialists, creating intense competition but also premium pricing structures. Upstate regions like the North Country and Southern Tier have fewer specialists, leading to longer wait times but often lower procedure costs. Patients in rural areas may travel 100+ miles to reach specialized endoscopy centers, affecting total treatment expenses.
Facility Type and Overhead Costs
Hospital-owned gastroenterology practices dominate New York's market, with systems like NewYork-Presbyterian, NYU Langone, and Northwell Health commanding premium rates through facility fees. Independent ambulatory surgery centers typically offer 30-50% lower costs for routine colonoscopies, though they may have limited capacity for complex cases. Academic medical centers justify higher pricing through research programs and subspecialty expertise.
Insurance Market Competition in New York
Empire BCBS holds significant market share as the state's Blue Cross affiliate, while UHC, Aetna, and Cigna compete aggressively in commercial markets. This competition has created varied reimbursement rates, with some insurers negotiating lower fees with independent practices while paying premium rates to prestigious hospital systems. The state's robust Medicaid managed care program also influences pricing structures across all payers.
Physician Supply and Demand in New York
With over 31,000 providers performing colonoscopy procedures, New York maintains strong specialist availability compared to many states. This large provider pool includes many subspecialists in advanced endoscopy and inflammatory bowel disease, creating options for complex cases but also supporting higher average pricing. The concentration of medical schools and residency programs in New York ensures steady specialist supply, though geographic distribution favors urban 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 New York
What is the average cost of a Colonoscopy with Biopsy visit in New York without insurance?
Does New York Medicaid cover Colonoscopy with Biopsy visits?
How do I find an affordable Colonoscopy with Biopsy near me in New York?
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 New York?
How does telemedicine affect the cost of seeing a Colonoscopy with Biopsy in New York?
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 |