CPT45378

Colonoscopy (Diagnostic) Cost in Nebraska

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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Nebraska Medicare physician rate (2026)

-7.5% vs national

Single statewide locality.

Nebraska (Hospital)
$152.70
Facility physician fee
Private plan est.
$455–$699
~130–200% of Medicare
Cash / self-pay est.
$280–$525
~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 Nebraska

Try a ZIP lookup for your part of Nebraska, from Omaha and Lincoln to Grand Island, Kearney, North Platte, Scottsbluff, and the Sandhills.

What colonoscopy (diagnostic) costs at hospitals near you

Everything above is a national average. The hospital you pick in Nebraska 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 Nebraska the office and hospital physician lines for this CPT differ by $197.00.

National vs Nebraska

National office$378.10
National hospital (physician)$164.67
Nebraska vs national8% below the national office rate of $378.10

Where Nebraska ranks for this CPT

Rank (lowest physician fee first)#9 of 51
Lowest stateArkansas ($335.05)
Highest stateAlaska ($441.84)

Colonoscopy (Diagnostic) and how Nebraska is priced

One locality prices all of Nebraska, with low geographic indices typical of the Plains, so Omaha, Lincoln, and the Sandhills ranch country share the same Medicare-approved amounts. The statewide setup means Nebraska's largest metro carries no fee schedule premium over its most remote village. Practice costs in Omaha do run above the rural average, but CMS averages that into one set of factors. Patients can treat the statewide numbers here as applicable anywhere in Nebraska.

Omaha is the state's medical anchor, with an academic medical center of national standing and a market that also serves western Iowa, while Lincoln adds a second urban hub. Outstate Nebraska depends heavily on critical access hospitals, and residents of the Panhandle often find Denver or Rapid City closer than Omaha for specialty care. Long travel distances are simply part of rural care planning here.

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 Nebraska: questions

Nebraska is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 45378 is $349.70 in an office and $152.70 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. Nebraska 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 $70 for the office physician line or $31 for the hospital physician line in Nebraska. Medigap may cover that 20%. This is not the hospital facility fee.

No. $349.70 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. Nebraska ranks #9 of 51 states on the physician line (8% 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.