Colonoscopy With Biopsy Cost in Utah
Colonoscopy and biopsy
$1,400Hospital 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
Utah Medicare physician rate (2026)
-4.7% 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 $566 on the Medicare allowed amount for colonoscopy with biopsy. 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 Utah
Look up your ZIP for your part of Utah, whether Salt Lake City, Provo, Ogden, Logan, St. George, or the rural east and canyon country.
What colonoscopy with biopsy costs at hospitals near you
Everything above is a national average. The hospital you pick in Utah 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 Utah the office and hospital physician lines for this CPT differ by $284.14.
National vs Utah
Where Utah ranks for this CPT
Colonoscopy With Biopsy and how Utah is priced
Utah's fee schedule operates as a single statewide locality with geographic indices slightly below the national average, so the Wasatch Front and the remote canyon country share identical Medicare-approved amounts. Salt Lake City's growth into a major regional economy has not split the locality. From Logan to St. George, the same adjustments apply, making the statewide figures a clean guide for any Utah address. As usual, the choice between hospital-based and office-based settings will move a bill more than in-state geography can.
The Wasatch Front from Ogden through Salt Lake City to Provo concentrates nearly all of Utah's specialty care, anchored by an academic medical center and a large integrated system known nationally for cost discipline. Salt Lake City is also the referral hub for a huge intermountain region covering parts of Idaho, Wyoming, and Nevada. Fast-growing St. George serves the southwest corner, but rural and canyon-country residents still travel far for procedures.
This procedure: This is a colonoscopy during which the physician passes small forceps through the scope to take one or more tissue samples, called cold biopsies, from the colon lining. It is used when the doctor sees inflammation, an unusual patch, or needs to test for conditions like microscopic colitis, which can only be diagnosed under a microscope. From the patient's perspective it is identical to any colonoscopy: prep the day before, IV sedation, a 20 to 45 minute exam, and home the same day.
What Is Colonoscopy With Biopsy?
This is a colonoscopy during which the physician passes small forceps through the scope to take one or more tissue samples, called cold biopsies, from the colon lining. It is used when the doctor sees inflammation, an unusual patch, or needs to test for conditions like microscopic colitis, which can only be diagnosed under a microscope. From the patient's perspective it is identical to any colonoscopy: prep the day before, IV sedation, a 20 to 45 minute exam, and home the same day.
What Affects the Cost
- –Every biopsy container sent to the lab is billed separately by pathology, and workups for conditions like microscopic colitis involve samples from multiple colon segments.
- –The physician fee for 45380 is higher than the diagnostic-only code 45378 because sampling was performed.
- –Facility choice between hospital outpatient and freestanding endoscopy center remains the largest single price driver.
- –Separate anesthesia billing applies when a dedicated provider administers sedation.
- –If a polyp is also removed by snare during the same exam, an additional code (45385) is billed alongside this one.
Questions to Ask Before Booking
- 1.Was my colonoscopy ordered as a screening or for symptoms, and how will biopsies affect what I owe under my specific plan?
- 2.How many specimen jars might be sent to pathology and what is the charge per jar?
- 3.Is the pathology lab in my insurance network?
- 4.If you also remove a polyp with a snare, will both procedure codes be billed and what does that total?
- 5.For Medicare patients: what coinsurance applies this year when a screening turns into a biopsy?
Other featured procedures in Utah
Colonoscopy With Biopsy in other states
Colonoscopy With Biopsy in Utah: questions
Utah is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 45380 is $457.54 in an office and $173.40 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. Utah 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 $92 for the office physician line or $35 for the hospital physician line in Utah. Medigap may cover that 20%. This is not the hospital facility fee.
No. $457.54 is only the physician's share. Adding Medicare's facility payment brings the total to about $1,400 in a hospital outpatient department, or about $834 at an ambulatory surgery centre. Anesthesia, pathology and other codes billed the same day are extra. Utah ranks #20 of 51 states on the physician line (5% below the national office rate of $479.97).