CPT45378

Colonoscopy (Diagnostic) Cost in Colorado

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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Colorado Medicare physician rate (2026)

+3.9% vs national

Single statewide locality.

Colorado (Hospital)
$165.81
Facility physician fee
Private plan est.
$511–$786
~130–200% of Medicare
Cash / self-pay est.
$314–$589
~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 Colorado

Enter a ZIP code to compare your area of Colorado, from Denver, Boulder, Fort Collins, and Colorado Springs to Grand Junction, the mountain resort counties, and the Eastern Plains.

What colonoscopy (diagnostic) costs at hospitals near you

Everything above is a national average. The hospital you pick in Colorado 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 Colorado the office and hospital physician lines for this CPT differ by $227.09.

National vs Colorado

National office$378.10
National hospital (physician)$164.67
Colorado vs national4% above the national office rate of $378.10

Where Colorado ranks for this CPT

Rank (lowest physician fee first)#43 of 51
Lowest stateArkansas ($335.05)
Highest stateAlaska ($441.84)

Colonoscopy (Diagnostic) and how Colorado is priced

Colorado's physician fees are set through a single statewide locality, so the Front Range and the Western Slope share one set of geographic adjustments despite very different local economies. The state's indices run modestly above the national midpoint, reflecting Denver-area wages and rents averaged against lower-cost rural areas. Because the locality is unified, mountain resort towns do not carry a higher Medicare fee schedule even though their private-market prices are famously steep. That gap between Medicare's uniform pricing and wide private-price variation is a defining feature of the Colorado market.

Care is concentrated along the Front Range from Fort Collins through Denver to Colorado Springs and Pueblo, where several large systems and an academic medical center compete. Mountain and plains communities depend on smaller hospitals, and residents there commonly drive to Denver or Grand Junction for specialty procedures. Resort-area facilities can bill far above what the corridor cities charge, so location shopping pays off in this state.

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 Colorado: questions

Colorado is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 45378 is $392.90 in an office and $165.81 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. Colorado 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 $79 for the office physician line or $33 for the hospital physician line in Colorado. Medigap may cover that 20%. This is not the hospital facility fee.

No. $392.90 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. Colorado ranks #43 of 51 states on the physician line (4% above 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.