Colonoscopy (Diagnostic) Cost in Montana
Diagnostic colonoscopy
$1,115Hospital outpatient total2026 Medicare, physician + facility- ✓Your ZIP's wage-adjusted hospital and surgery centre rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
Montana Medicare physician rate (2026)
-0.0% vs nationalSingle statewide locality.
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 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 Montana
Look up your ZIP for local context, whether you are in Billings, Missoula, Bozeman, Great Falls, Helena, Kalispell, or one of Montana's frontier counties.
What colonoscopy (diagnostic) costs at hospitals near you
Everything above is a national average. The hospital you pick in Montana 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.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
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 Montana the office and hospital physician lines for this CPT differ by $213.43.
National vs Montana
Where Montana ranks for this CPT
Colonoscopy (Diagnostic) and how Montana is priced
Montana runs on a single statewide locality with geographic indices near the bottom of the national range, so its published Medicare rates are uniform across nearly 150,000 square miles. Billings and a remote Hi-Line town share identical adjustment factors, a simplicity that belies the enormous distances involved in actually reaching care. CMS applies a rural floor to work adjustments that benefits frontier states like this one. For pricing purposes, Montana is one market; for access purposes, it is dozens of small ones.
Billings hosts the state's largest medical community and serves as a referral hub not just for Montana but for northern Wyoming and the western Dakotas, with Missoula, Great Falls, Bozeman, and Kalispell anchoring their own regions. Frontier counties may be hours from the nearest hospital that performs a given procedure. Some Montanans travel to Salt Lake City, Denver, or Seattle for highly specialized care.
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 Montana
Colonoscopy (Diagnostic) in other states
Colonoscopy (Diagnostic) in Montana: questions
Montana is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 45378 is $378.07 in an office and $164.64 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. Montana 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 $76 for the office physician line or $33 for the hospital physician line in Montana. Medigap may cover that 20%. This is not the hospital facility fee.
No. $378.07 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. Montana ranks #35 of 51 states on the physician line (within 2% of the national office rate of $378.10).