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National price data · 2,452 hospitals

Colonoscopy with biopsy cost

What a colonoscopy with biopsy costs across the U.S. — and the fair price to aim for.

Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Near Fair BaseRate Benchmark
1.00×vs. Fair Market Price
Position vs. 1.00× Fair PriceRight at U.S. Average (0%) 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).86/100 · Verified
86/100Hover Any Check Below to See How Prices Were Audited
File Completeness90Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic88Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment86Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing83Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount84Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Value Leader
CMS Star RatingNot RatedOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety ScoreNot ScoredComposite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Doctors' Center Hospital, Inc prices routine shoppable procedures near 0.5× Medicare (p50 1.41×) while skewing captive emergency, lab, and upper-quartile codes to 1.7× Medicare (p75 1.60×, +13% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#16 of 17 in PR · 88th State Percentile#2,251 of 3,385 in U.S. · 66th National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 0.54× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 4% of shoppable procedures (25/100 Cash Honesty)
  • 1-Star CMS clinical rating with 72% patient recommendation (55/100 safety score)
  • Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Watchout

Where You Can Get Burned (Markup Traps)

  • Even at low-cost facilities (1.00× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
  • Captive ER (0.4×) & laboratory (0.9×) services average 3.40× higher multiples than routine shoppable care (0.5×)
  • Specialty infusion drugs (J-codes) average 1.2× Medicare — verify per-unit billing on itemized statements
  • Unnegotiated chargemaster list prices average 2.0× Medicare (45¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
0.5× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER3.40× Divergence
1.7× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+13% Upper Tail
Q25 0.54× · Q50 1.41× · Q75 1.60×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.
Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×
Front-Door Shoppable CareFront-Door Shoppable
0.5× MedicareGood
Outpatient Surgery & ORBack-Door Captive
0.8× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
0.5× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
0.5× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
0.9× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
1.2× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
4% Cash Edge · 25/100Watchout
CMS Clinical Safety & Star ValueIntegrity & Outcomes
1 CMS · 55/100Elevated
National Geographic Price Intelligence · 50-State + DC/PR Cartogram

National State Price Index Heatmap · Colonoscopy with biopsy

State commercial price index vs. U.S. median (1.00×) and average Medicare multiple across all 53 priced states & territories

<0.93× Below Fair Price 0.93–1.05× Near Average 1.05–1.18× Elevated >1.18× High-Cost State
MT0.35×0.7× MedPR0.35×0.3× MedWY0.35×0.8× MedIA0.37×1.0× MedME0.38×1.0× MedMI0.40×1.0× MedVT0.40×1.0× MedOR0.46×1.2× MedID0.59×1.5× MedWV0.64×1.7× MedKS0.85×2.2× MedLA0.86×2.2× MedAL0.88×2.3× MedNE0.88×2.3× MedAR0.91×2.4× MedMN0.92×2.4× MedKY0.93×2.4× MedMS0.94×2.5× MedNC0.94×2.4× MedOH0.94×2.5× MedPA0.94×2.5× MedSC0.94×2.4× MedND0.96×2.5× MedSD0.96×2.5× MedTN0.97×2.5× MedNM0.99×2.6× MedCO1.00×2.6× MedIN1.00×2.6× MedNH1.00×2.6× MedTX1.00×2.6× MedIL1.03×2.7× MedAZ1.04×2.7× MedAK1.06×2.8× MedHI1.07×2.8× MedRI1.07×2.8× MedMO1.08×2.8× MedCT1.09×2.8× MedNY1.11×2.9× MedWA1.14×3.0× MedUT1.15×3.0× MedMA1.16×3.0× MedOK1.18×3.1× MedDE1.21×3.2× MedNV1.21×3.2× MedCA1.22×3.2× MedWI1.23×3.2× MedFL1.26×3.3× MedMD1.31×3.4× MedVA1.67×4.4× MedNJ1.73×4.5× MedGA1.83×4.8× MedDC2.00×5.2× Med
5 Lowest-Price States (Confounder-Isolated Value Leaders)
MT0.35×(0.7×)PR0.35×(0.3×)WY0.35×(0.8×)IA0.37×(1.0×)ME0.38×(1.0×)
5 Highest-Markup States (Strict Bill Audit Recommended)
DC2.00×(5.2×)GA1.83×(4.8×)NJ1.73×(4.5×)VA1.67×(4.4×)MD1.31×(3.4×)
The BaseRate high confidence
$1,269
the fair national price for a colonoscopy with biopsy
typically $332–$2,996 across 2,452 hospitals · how we calculate it
modeled estimate · not a bill or quote
2,452
hospitals priced
52
states
9×
price spread — where shopping matters
2.6×
vs. Medicare

Across 2,452 hospitals in 52 states, a colonoscopy with biopsy has a fair BaseRate of $1,269 and typically costs $332–$2,996. The cheapest state is PR; the priciest is GA.

Cheapest hospitals for a colonoscopy with biopsy

Colonoscopy with biopsy cost by state

AK $1,328 7 hospitals AL $1,104 39 hospitals AR $1,138 34 hospitals AZ $1,307 44 hospitals CA $1,532 183 hospitals CO $1,253 52 hospitals CT $1,364 15 hospitals DC $2,516 2 hospitals DE $1,519 6 hospitals FL $1,587 138 hospitals GA $2,300 71 hospitals HI $1,350 12 hospitals IA $465 61 hospitals ID $738 20 hospitals IL $1,291 83 hospitals IN $1,257 74 hospitals KS $1,073 71 hospitals KY $1,164 39 hospitals LA $1,079 53 hospitals MA $1,457 37 hospitals MD $1,645 2 hospitals ME $476 22 hospitals MI $501 67 hospitals MN $1,158 59 hospitals MO $1,357 66 hospitals MS $1,178 43 hospitals MT $347 13 hospitals NC $1,175 51 hospitals ND $1,209 12 hospitals NE $1,108 50 hospitals NH $1,256 13 hospitals NJ $2,171 47 hospitals NM $1,246 11 hospitals NV $1,519 20 hospitals NY $1,395 71 hospitals OH $1,186 102 hospitals OK $1,482 38 hospitals OR $584 27 hospitals PA $1,186 90 hospitals PR $153 5 hospitals RI $1,339 5 hospitals SC $1,175 43 hospitals SD $1,205 13 hospitals TN $1,221 67 hospitals TX $1,262 213 hospitals UT $1,450 34 hospitals VA $2,092 61 hospitals VT $501 10 hospitals WA $1,433 50 hospitals WI $1,551 82 hospitals WV $800 16 hospitals WY $384 8 hospitals
Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 36.3%

Audit a Bill or Quote at U.S. Hospital Benchmark (Zero PHI Required)

Fair BaseRate™ $1,269
Medicare Rate $736
Self-Pay Cash Request Quote
Insurer Median $1,256
Pre-filled with U.S. Hospital Benchmark’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $1,094 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $1,094

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $1,094).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask U.S. Hospital Benchmark's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$1,745 Above Fair BaseRate

Negotiate Toward $1,269 Fair BaseRate ($736 Medicare)

Your bill ($3,014) is $1,745 above the denoised Fair BaseRate ($1,269) and 4.1× the $736 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.