Cost of a Colonoscopy with Biopsy Visit
in Vermont
Reviewed by Momentary Medical Group West PC
Vermont's rural healthcare delivery model creates unique cost dynamics for specialty procedures, with the state maintaining 337 active Colonoscopy with Biopsy providers despite its small population. Patients typically pay between $316 and $1,042 for these procedures, with a median out-of-pocket cost of $537 based on negotiated insurance rates. The Green Mountain State's emphasis on community-based healthcare means patients can browse providers across both academic medical centers and smaller regional facilities throughout Vermont.
Average
$632
Median
$537
Lowest
$317
Highest
$1,042
Providers
337
9% above national average
Compare Similar Procedures
How does colonoscopy with biopsy compare to related procedures in Vermont?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $106 | $347 | $801 | 334 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $333 | $553 | $1,096 | 337 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $211 | $362 | $673 | 325 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $273 | $476 | $907 | 339 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $11 | $18 | $73 | 352 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $61 | $171 | $471 | 348 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $42 | $124 | $341 | 337 |
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 Vermont
Vermont's healthcare costs run approximately 15% above the national average, reflecting the challenges of delivering specialized care across a rural state with limited population density. The state's commitment to maintaining local healthcare access despite geographic barriers creates unique cost pressures compared to more urbanized markets.
Urban vs. Rural Provider Availability
The majority of Vermont's gastroenterologists practice in the Burlington-Chittenden County area, with limited specialists available in rural regions like the Northeast Kingdom or southern Vermont. Patients in rural areas may need to travel significant distances for colonoscopy procedures, potentially adding transportation costs to their overall healthcare expenses. Some rural hospitals partner with traveling specialists or offer visiting gastroenterology clinics to improve access.
Facility Type and Overhead Costs
Vermont's healthcare landscape includes major systems like UVM Medical Center and Dartmouth-Hitchcock, alongside smaller community hospitals and independent gastroenterology practices. Hospital-based outpatient departments typically have higher overhead costs and facility fees compared to independent ambulatory surgery centers. The state's rural nature means some facilities serve large geographic areas, potentially affecting their cost structures and pricing models.
Insurance Market Competition in Vermont
BCBS VT and MVP Health Care dominate Vermont's commercial insurance market, creating less competitive pressure on negotiated rates compared to states with more insurers. This concentrated market can result in similar pricing across different plans but may limit patients' ability to find significantly lower-cost network options. The state's small market size also means insurers have less leverage in rate negotiations with the limited number of specialist providers.
Physician Supply and Demand in Vermont
With 337 active Colonoscopy with Biopsy providers serving Vermont's population of approximately 650,000, the state maintains reasonable specialist access despite its rural nature. This provider-to-population ratio is relatively favorable compared to other rural states, though geographic distribution remains uneven. The adequate supply helps moderate pricing pressures, though travel requirements for rural patients can still create access barriers beyond direct procedure costs.
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 Vermont
What is the average cost of a Colonoscopy with Biopsy visit in Vermont without insurance?
Does Vermont Medicaid cover Colonoscopy with Biopsy visits?
How do I find an affordable Colonoscopy with Biopsy near me in Vermont?
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 Vermont?
How does telemedicine affect the cost of seeing a Colonoscopy with Biopsy in Vermont?
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 |