Cost of a Colonoscopy with Biopsy Visit
in Pennsylvania
Reviewed by Momentary Medical Group West PC
Pennsylvania's healthcare market runs approximately 9% above national averages, with concentrated provider networks in Philadelphia and Pittsburgh driving regional cost variations. Colonoscopy with Biopsy patients typically pay between $80 and $2,116, with a median out-of-pocket cost of $373 based on negotiated insurance rates across 1,414 active providers statewide. Pennsylvania maintains a robust network of gastroenterology specialists, allowing patients to browse multiple providers when comparing costs and scheduling preferences.
Average
$857
Median
$373
Lowest
$80
Highest
$2,117
Providers
1,414
48% above national average
Compare Similar Procedures
How does colonoscopy with biopsy compare to related procedures in Pennsylvania?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $85 | $323 | $1,830 | 1,067 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $469 | $2,338 | 1,327 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $90 | $274 | $715 | 1,120 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $80 | $273 | $1,647 | 1,592 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $13 | $55 | $90 | 2,207 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $61 | $155 | $677 | 1,469 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $42 | $85 | $328 | 1,801 |
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 Pennsylvania
Pennsylvania's healthcare costs run approximately 9% above the national average, driven by concentrated provider markets in Philadelphia and Pittsburgh where major health systems dominate pricing. The state's mix of densely populated urban corridors and rural counties creates significant cost and access disparities across regions.
Urban vs. Rural Provider Availability
Pennsylvania's gastroenterology specialists concentrate heavily in the Philadelphia and Pittsburgh metropolitan areas, with limited availability in rural counties across central and northern Pennsylvania. Rural residents often travel 50+ miles for specialized procedures, potentially adding travel costs but sometimes finding lower facility fees. The state's mountainous terrain and spread-out communities make mobile or satellite gastroenterology services less common than in flatter states.
Facility Type and Overhead Costs
Major health systems like UPMC in Pittsburgh and Penn Medicine in Philadelphia operate most hospital-based outpatient endoscopy centers, typically charging higher facility fees than independent surgery centers. Pennsylvania's certificate-of-need laws historically limited competition among ambulatory surgery centers, though recent regulatory changes have increased options in some markets. Academic medical centers associated with Temple, Jefferson, and University of Pennsylvania often charge premium rates for procedures performed by faculty physicians.
Insurance Market Competition in Pennsylvania
Pennsylvania's insurance market splits between Highmark (dominant in western PA), Independence Blue Cross (dominant in southeastern PA), and UnitedHealthcare with growing statewide presence. This regional concentration means fewer competing networks in each area, potentially leading to higher negotiated rates than in more competitive insurance markets. The lack of a robust public option beyond Medicaid expansion limits insurer negotiating pressure on provider rates.
Physician Supply and Demand in Pennsylvania
With 1,414 active providers performing colonoscopy with biopsy procedures, Pennsylvania maintains adequate gastroenterology capacity in urban areas but faces shortages in rural counties. The state's aging population increases demand for colorectal cancer screening, creating scheduling pressure and potentially supporting higher prices in high-demand markets. Pennsylvania's medical schools graduate substantial numbers of gastroenterology fellows, but many relocate to other states after training, limiting supply growth.
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 Pennsylvania
What is the average cost of a Colonoscopy with Biopsy visit in Pennsylvania without insurance?
Does Pennsylvania Medicaid cover Colonoscopy with Biopsy visits?
How do I find an affordable Colonoscopy with Biopsy near me in Pennsylvania?
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 Pennsylvania?
How does telemedicine affect the cost of seeing a Colonoscopy with Biopsy in Pennsylvania?
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 |