How Much Does a Colonoscopy (Diagnostic) Cost in Missouri?
Diagnostic colonoscopy
$1,115Hospital outpatient total2026 Medicare, physician + facilityUnder 2026 Medicare rates, a colonoscopy (diagnostic) costs about $1,115 in total at a hospital outpatient department or about $675 at an ambulatory surgery center, counting both the physician and the facility (national rates). The physician's own fee in Missouri averages $161, from $158 to $163 across 3 Medicare localities.
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- ✓The add-on codes that typically land on the bill
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Missouri Medicare physician rate (2026)
-5.7% vs nationalAverage of 3 localities. Office range $342.11–$365.73.
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.
Choosing a surgery center 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 center.
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 Missouri
Enter a ZIP code to see which Missouri locality covers you: metro St. Louis, metro Kansas City, or rest-of-state areas like Springfield, Columbia, Joplin, and the Bootheel.
What colonoscopy (diagnostic) costs at hospitals near you
Everything above is a national average. The hospital you pick in Missouri moves the bill more than anything else you control.
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 center 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 Missouri the office and hospital physician lines for this CPT differ by $195.85.
National vs Missouri
Where Missouri ranks for this CPT
CPT 45378 by Missouri locality
| Locality | Office |
|---|---|
| metropolitan st. louis | $365.73 |
| metropolitan kansas city | $362.03 |
| rest of missouri | $342.11 |
PE GPCI ranges from 0.862 to 0.952 in Missouri. That index is why the same CPT is not one price statewide.
Colonoscopy (Diagnostic) and how Missouri is priced
Missouri is a three-locality state: metropolitan St. Louis and metropolitan Kansas City are each priced separately, and everywhere else falls into a rest-of-state locality with lower geographic adjustments. Both metro localities approve higher amounts than outstate Missouri, and the Kansas City locality applies only to the Missouri side of that metro, since the Kansas side prices under Kansas's statewide locality. Springfield, Columbia, and the rural counties all share rest-of-state factors. The metro-versus-outstate gap is the main pricing story here.
St. Louis and Kansas City hold the state's academic medical centers and most of its specialty depth, drawing patients from far beyond Missouri's borders, including southern Illinois and eastern Kansas. Outstate Missouri is served by regional hubs in Springfield, Columbia, and Cape Girardeau, with the Ozarks and Bootheel among the harder places to reach specialty care. Rural hospital viability has been a persistent concern across the 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?
Other featured procedures in Missouri
Colonoscopy (Diagnostic) in other states
Colonoscopy (Diagnostic) in Missouri: questions
Under 2026 Medicare rates, a colonoscopy (diagnostic) costs about $1,115 in total at a hospital outpatient department or about $675 at an ambulatory surgery center, counting both the physician and the facility (national rates). The physician's own fee in Missouri averages $161, from $158 to $163 across 3 Medicare localities. Enter a ZIP for the exact Missouri locality.
Yes. CMS splits Missouri into 3 payment localities. For this CPT the office physician fee spans $23.62 from the lowest to highest locality. Enter a ZIP code to see which Missouri locality covers you: metro St. Louis, metro Kansas City, or rest-of-state areas like Springfield, Columbia, Joplin, and the Bootheel.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $71 for the office physician line or $32 for the hospital physician line in Missouri. Medigap may cover that 20%. This is not the hospital facility fee.
No. $160.77 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 center. Anesthesia, pathology and other codes billed the same day are extra. Missouri ranks #17 of 51 states on the physician line (6% below the national office rate of $378.10).