Cost of a Colonoscopy with Biopsy Visit
in Rhode Island
Reviewed by Momentary Medical Group West PC
Rhode Island's concentrated healthcare market, with most specialists clustered around Providence and Newport, creates unique cost dynamics for Colonoscopy with Biopsy procedures. Patients typically pay between $80 and $2,117 for a Colonoscopy with Biopsy visit, with a median out-of-pocket cost of $535. The Ocean State has 77 active Colonoscopy with Biopsy providers serving its population of just over one million residents.
Average
$910
Median
$535
Lowest
$80
Highest
$2,117
Providers
77
58% above national average
Compare Similar Procedures
How does colonoscopy with biopsy compare to related procedures in Rhode Island?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $91 | $423 | $1,830 | 63 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $673 | $2,338 | 75 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $109 | $391 | $718 | 58 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $80 | $418 | $1,647 | 83 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $28 | $90 | 108 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $64 | $207 | $895 | 90 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $50 | $115 | $328 | 80 |
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 Rhode Island
Rhode Island's healthcare costs run approximately 13% above the national average, driven by the state's high cost of living and concentrated provider market. The Ocean State's small geographic footprint creates less price variation than larger states, but significant cost differences still exist between urban Providence and rural communities.
Urban vs. Rural Provider Availability
Most of Rhode Island's gastroenterologists practice within a 20-mile radius of Providence, creating accessibility challenges for residents of Washington County and Block Island. Rural patients often face longer wait times and may need to travel to Providence or Newport for specialized procedures. This geographic concentration allows urban providers to command higher prices due to convenience and market dominance.
Facility Type and Overhead Costs
Hospital-owned practices affiliated with Lifespan (Rhode Island Hospital, The Miriam Hospital) and Care New England typically charge higher fees due to facility overhead and academic medical center costs. Independent gastroenterology groups and ambulatory surgery centers often provide the same quality care at 20-30% lower costs. The state's Certificate of Need laws have limited the number of new endoscopy facilities, reducing price competition.
Insurance Market Competition in Rhode Island
Blue Cross Blue Shield of Rhode Island dominates the individual and small group markets, holding over 60% market share and significant negotiating power with providers. UnitedHealthcare and Tufts Health Plan provide competition primarily in the employer market, but limited carrier options result in less aggressive rate negotiations. This concentrated insurance market contributes to higher negotiated rates compared to states with more robust competition.
Physician Supply and Demand in Rhode Island
With 77 active Colonoscopy with Biopsy providers serving approximately 1.1 million residents, Rhode Island maintains adequate specialist coverage compared to national benchmarks. However, many gastroenterologists also serve patients from southeastern Massachusetts, creating appointment scheduling pressures. The state's aging population and increased colorectal cancer screening recommendations continue to drive demand growth, supporting current pricing levels.
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 Rhode Island
What is the average cost of a Colonoscopy with Biopsy visit in Rhode Island without insurance?
Does Rhode Island Medicaid cover Colonoscopy with Biopsy visits?
How do I find an affordable Colonoscopy with Biopsy near me in Rhode Island?
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 Rhode Island?
How does telemedicine affect the cost of seeing a Colonoscopy with Biopsy in Rhode Island?
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 |