Colonoscopy (Diagnostic) Cost in South Dakota
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
South Dakota Medicare physician rate (2026)
-2.4% 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 South Dakota
Try a ZIP lookup for your area, whether Sioux Falls, Rapid City and the Black Hills, Aberdeen, Pierre, or the reservation and ranch country in between.
What colonoscopy (diagnostic) costs at hospitals near you
Everything above is a national average. The hospital you pick in South Dakota 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 South Dakota the office and hospital physician lines for this CPT differ by $213.44.
National vs South Dakota
Where South Dakota ranks for this CPT
Colonoscopy (Diagnostic) and how South Dakota is priced
All of South Dakota falls under a single payment locality with indices near the bottom of the national scale, cushioned by the work index floor for low-cost states. Sioux Falls and a West River ranch community share one published fee schedule. The state's east-west split, with most people and providers east of the Missouri River, has no counterpart in the pricing structure. That leaves South Dakota with some of the simplest and lowest Medicare pricing in the country.
Sioux Falls has become a genuine regional medical hub, headquarters to large systems whose reach extends across the Dakotas and into neighboring states, while Rapid City anchors care for the West River side and the Black Hills. Vast stretches between them rely on critical access hospitals and tribal facilities, some of the most isolated care settings in America. Referrals to Sioux Falls, Rapid City, or out of state are a routine part of rural 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 South Dakota
Colonoscopy (Diagnostic) in other states
Colonoscopy (Diagnostic) in South Dakota: questions
South Dakota is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 45378 is $369.01 in an office and $155.57 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. South Dakota 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 $74 for the office physician line or $31 for the hospital physician line in South Dakota. Medigap may cover that 20%. This is not the hospital facility fee.
No. $369.01 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. South Dakota ranks #25 of 51 states on the physician line (2% below the national office rate of $378.10).