Cost of a Colonoscopy with Biopsy Visit
in West Virginia
Reviewed by Momentary Medical Group West PC
West Virginia's mountainous terrain and dispersed population create unique challenges for accessing specialist care across the state's 55 counties. For patients requiring a Colonoscopy with Biopsy visit, costs typically range from $85 to $1,329, with a median rate of $308 based on negotiated insurance rates from 163 active providers throughout West Virginia. The state's Medicaid expansion and dominant insurers like Highmark WV help many residents access affordable specialist care, though geographic barriers remain significant for rural communities.
Average
$574
Median
$308
Lowest
$85
Highest
$1,329
Providers
163
1% below national average
Compare Similar Procedures
How does colonoscopy with biopsy compare to related procedures in West Virginia?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $85 | $357 | $1,395 | 106 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $98 | $410 | $1,538 | 153 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $93 | $274 | $889 | 98 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $80 | $298 | $1,647 | 122 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $14 | $91 | 304 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $66 | $155 | $1,167 | 201 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $50 | $68 | $215 | 208 |
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 West Virginia
Healthcare costs in West Virginia run approximately 2% below national averages, reflecting the state's lower cost of living and rural economics. The Mountain State's challenging geography and sparse population density create unique cost pressures, particularly for specialized procedures requiring advanced equipment and expertise.
Urban vs. Rural Provider Availability
Charleston, Huntington, and Morgantown anchor West Virginia's specialist care, while the state's 35 rural counties often lack local gastroenterology services entirely. Patients in rural areas frequently travel 50+ miles for colonoscopy procedures, adding transportation costs and limiting price competition among providers.
Facility Type and Overhead Costs
Hospital-based outpatient centers dominate West Virginia's colonoscopy market, with major health systems like Charleston Area Medical Center and WVU Medicine setting regional pricing standards. Independent ambulatory surgery centers are less common but often offer more competitive rates due to lower overhead costs and streamlined operations.
Insurance Market Competition in West Virginia
Limited insurer competition between Highmark WV, UHC, and Aetna creates a concentrated market where negotiated rates vary less dramatically than in more competitive states. This market structure can benefit patients through consistent pricing but may limit opportunities for significant cost savings through insurer shopping.
Physician Supply and Demand in West Virginia
With 163 providers performing colonoscopy with biopsy procedures statewide, West Virginia faces a relative shortage given its aging population and high rates of gastrointestinal conditions. This supply constraint can drive up costs and extend wait times, particularly in rural regions where specialist availability is most limited.
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 West Virginia
What is the average cost of a Colonoscopy with Biopsy visit in West Virginia without insurance?
Does West Virginia Medicaid cover Colonoscopy with Biopsy visits?
How do I find an affordable Colonoscopy with Biopsy near me in West 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 West Virginia?
How does telemedicine affect the cost of seeing a Colonoscopy with Biopsy in West 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 |