Cost of a Colonoscopy with Biopsy Visit
in Virginia
Reviewed by Momentary Medical Group West PC
Virginia's healthcare market operates approximately 3% above national cost averages, with Medicaid expansion providing broader coverage access across the Commonwealth. Patients seeking a Colonoscopy with Biopsy typically encounter negotiated rates between $98 and $830, with a median cost of $343 based on transparency data from over 3,200 active providers throughout Virginia. The state's mix of urban medical centers in Northern Virginia and Richmond alongside rural clinics creates diverse pricing options for patients across all regions.
Average
$423
Median
$343
Lowest
$98
Highest
$830
Providers
3,248
27% below national average
Compare Similar Procedures
How does colonoscopy with biopsy compare to related procedures in Virginia?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $124 | $297 | $682 | 2,843 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $98 | $398 | $916 | 3,147 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $95 | $228 | $551 | 2,703 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $90 | $257 | $728 | 2,890 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $13 | $22 | $98 | 3,469 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $59 | $150 | $390 | 3,292 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $36 | $85 | $215 | 2,860 |
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 Virginia
Virginia's healthcare costs run approximately 3% above national averages, reflecting the state's proximity to high-cost Washington DC markets and concentration of academic medical centers. The Commonwealth's diverse geography from Appalachian rural communities to dense Northern Virginia suburbs creates significant cost variations driven by local economic conditions and provider competition.
Urban vs. Rural Provider Availability
Northern Virginia and the Richmond-Petersburg area concentrate most gastroenterology specialists, creating competitive pricing but higher overhead costs due to expensive real estate and staff wages. Rural regions in Southwest Virginia and the Shenandoah Valley have fewer specialists, potentially requiring longer travel but offering lower base rates at community hospitals and regional medical centers.
Facility Type and Overhead Costs
Hospital systems like VCU Health, Sentara, and Inova operate many outpatient gastroenterology clinics with higher overhead costs reflected in facility fees and procedure charges. Independent gastroenterology practices throughout Virginia often provide more competitive pricing without hospital facility fees, though they may have fewer locations and scheduling flexibility.
Insurance Market Competition in Virginia
Strong competition among Anthem Blue Cross Blue Shield, Optima Health, and UnitedHealthcare has helped moderate premium increases while maintaining broad provider networks across the state. Anthem's dominant market position in rural Virginia provides leverage in rate negotiations, while urban areas benefit from more insurer competition driving down negotiated rates with specialists.
Physician Supply and Demand in Virginia
Over 3,200 providers offer colonoscopy services throughout Virginia, indicating relatively good access compared to national averages and helping moderate pricing through competition. The concentration of gastroenterologists in academic centers like UVA and VCU creates training pipelines that maintain adequate specialist supply, though rural areas still face some access challenges requiring telemedicine or travel to urban centers.
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 Virginia
What is the average cost of a Colonoscopy with Biopsy visit in Virginia without insurance?
Does Virginia Medicaid cover Colonoscopy with Biopsy visits?
How do I find an affordable Colonoscopy with Biopsy near me in Virginia?
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 Virginia?
How does telemedicine affect the cost of seeing a Colonoscopy with Biopsy in Virginia?
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 |