CPT45378

Colonoscopy (Diagnostic) Cost in Alabama

Diagnostic colonoscopy

$1,115Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Alabama Medicare physician rate (2026)

-10.1% vs national

Single statewide locality.

Alabama (Hospital)
$153.13
Facility physician fee
Private plan est.
$442–$680
~130–200% of Medicare
Cash / self-pay est.
$272–$510
~80–150% of Medicare

What the whole procedure costs

The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.

Surgery centre, total
$675
$165 physician + $510 facility
Physician fee alone
$165
Only 15% of the hospital total

Choosing a surgery centre over a hospital saves about $440 on the Medicare allowed amount for colonoscopy (diagnostic). Ask whether your procedure can be done at an ambulatory surgery centre.

This is Medicare's separate payment to the facility on top of the physician's fee. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.

Your ZIP in Alabama

Enter a ZIP code to see figures for your part of Alabama, whether that is Birmingham, Huntsville, Mobile, Montgomery, or a rural county in the Black Belt or the Appalachian north.

What colonoscopy (diagnostic) costs at hospitals near you

Everything above is a national average. The hospital you pick in Alabama moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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What these numbers are

Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. In Alabama the office and hospital physician lines for this CPT differ by $186.75.

National vs Alabama

National office$378.10
National hospital (physician)$164.67
Alabama vs national10% below the national office rate of $378.10

Where Alabama ranks for this CPT

Rank (lowest physician fee first)#3 of 51
Lowest stateArkansas ($335.05)
Highest stateAlaska ($441.84)

Colonoscopy (Diagnostic) and how Alabama is priced

Medicare treats Alabama as one statewide payment locality, so the same geographic adjustment factors apply to a physician visit in Birmingham as in a small Wiregrass town. That single-locality setup keeps the published fee schedule uniform across the state, even though the cost of running a practice differs between the larger metros and rural counties. Alabama's geographic indices sit below the national average, which places its Medicare-approved amounts among the lower tiers nationally. What varies for patients is less the fee schedule itself and more the setting where care is delivered, since hospital outpatient billing can add facility fees on top of the physician rate.

Birmingham anchors the state's medical economy with a major academic medical center and a concentration of specialists, while Huntsville, Mobile, and Montgomery support sizable regional systems. Much of rural Alabama, particularly the Black Belt counties, faces thin physician coverage, so patients there often travel to a metro for specialty care. That travel pattern means the price you compare should be for where you will actually be treated, not just where you live.

This procedure: A diagnostic colonoscopy examines the entire large intestine with a flexible camera inserted through the rectum, looking for the cause of symptoms such as bleeding, chronic diarrhea, or abdominal pain, or following up an abnormal stool test. You complete a bowel-cleansing prep the day before, receive IV sedation, and the exam takes 20 to 45 minutes. This specific code means the doctor looked but did not remove or sample anything; you go home the same day with a driver.

What Is Colonoscopy (Diagnostic)?

A diagnostic colonoscopy examines the entire large intestine with a flexible camera inserted through the rectum, looking for the cause of symptoms such as bleeding, chronic diarrhea, or abdominal pain, or following up an abnormal stool test. You complete a bowel-cleansing prep the day before, receive IV sedation, and the exam takes 20 to 45 minutes. This specific code means the doctor looked but did not remove or sample anything; you go home the same day with a driver.

What Affects the Cost

  • Facility setting is the dominant variable: hospital outpatient departments routinely charge several times what freestanding endoscopy centers do.
  • Anesthesia billed separately, particularly monitored propofol sedation, adds a meaningful independent charge.
  • If any polyp or tissue is encountered and removed, the procedure converts to a higher-paying code (45380 or 45385) plus pathology fees.
  • The bowel prep kit may be a pharmacy cost, with prescription-only preps costing more than over-the-counter regimens.
  • A pre-procedure consult with the gastroenterologist is often billed as its own office visit.

Questions to Ask Before Booking

  • 1.Is my procedure being ordered as diagnostic or screening, and what exactly will I owe under each?
  • 2.If this follows a positive Cologuard or FIT test, will it be billed with the screening modifier so my cost sharing is waived?
  • 3.What are the facility fees at the hospital versus the endoscopy center you use?
  • 4.Who provides sedation and are they in network?
  • 5.If you find and remove a polyp, what does my estimate become?

Colonoscopy (Diagnostic) in Alabama: questions

Alabama is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 45378 is $339.88 in an office and $153.13 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. Alabama uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $68 for the office physician line or $31 for the hospital physician line in Alabama. Medigap may cover that 20%. This is not the hospital facility fee.

No. $339.88 is only the physician's share. Adding Medicare's facility payment brings the total to about $1,115 in a hospital outpatient department, or about $675 at an ambulatory surgery centre. Anesthesia, pathology and other codes billed the same day are extra. Alabama ranks #3 of 51 states on the physician line (10% below the national office rate of $378.10).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.