Colonoscopy Cost in Houston, TX

This page displays published hospital pricing data for colonoscopy procedures across metro area facilities, compiled from CMS-mandated hospital transparency files that hospitals must publish annually. Hospital facility fees cover the use of the procedure room, endoscopic equipment, monitoring devices, nursing staff, and recovery room services. Two main billing codes apply: HCPCS 45378 for screening colonoscopy and HCPCS 45380 for colonoscopy with biopsy, which involves additional processing charges. The pricing data represents the facility portion of total procedure costs and does not include separate physician professional fees.

Data last updated: 2026-02-28

Screening Colonoscopy (HCPCS 45378)

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Hospital	Gross Charge	Cash Price	Low Insured	High Insured
Baylor St Luke's Medical	$0	$0	$345.58	$7,221	Schedule →
Harris Health	$3,880	$1,835.24	N/A	N/A	Schedule →
HCA Clear Lake	$0	$0	$4,255	$4,255	Schedule →
HCA Conroe	$0	$0	$4,690	$4,690	Schedule →
HCA Kingwood	$0	$0	$344.93	$11,500	Schedule →
HCA Mainland	$0	$0	$352.49	$11,500	Schedule →
HCA Medical Center	$0	$0	$352.49	$4,690	Schedule →
HCA North Cypress	$0	$0	$414.7	$3,993	Schedule →
HCA Northwest	$0	$0	$352.49	$4,690	Schedule →
HCA Pearland	$0	$0	$352.49	$4,690	Schedule →
HCA Southeast	$0	$0	$344.93	$11,500	Schedule →
HCA Tomball	$0	$0	$352.49	$4,690	Schedule →
HCA West	$0	$0	$321.93	$410.63	Schedule →
Houston Methodist	$1,038	$519	$934.2	$5,545	Schedule →
MH Cypress	$4,817	$1,541.44	$934.2	$1,774.97	Schedule →
MH Greater Heights	$4,588	$1,468.16	$934.2	$1,774.97	Schedule →
MH Katy	$4,588	$1,468.16	$934.2	$1,774.97	Schedule →
MH Memorial City	$4,588	$1,468.16	$934.2	$1,774.97	Schedule →
MH Northeast	$4,588	$1,468.16	$934.2	$1,774.97	Schedule →
MH Pearland	$4,588	$1,468.16	$934.2	$1,774.97	Schedule →
MH Southeast	$4,588	$1,468.16	$934.2	$1,774.97	Schedule →
MH Southwest	$4,588	$1,468.16	$934.2	$1,774.97	Schedule →
MH Sugar Land	$4,588	$1,468.16	$934.2	$1,774.97	Schedule →
Memorial Hermann TMC	$4,817	$1,541.44	$934.2	$1,774.97	Schedule →
MH Woodlands	$4,588	$1,468.16	$934.2	$1,774.97	Schedule →
St Luke's Brazosport	$0	$0	$345.58	$2,831	Schedule →
St Luke's Lakeside	$0	$0	$328.5	$7,221	Schedule →
St Luke's Patients Medica	$3,931.2	$1,375.92	$312.07	$7,221	Schedule →
St Luke's Springwoods Vil	$0	$0	$345.58	$7,221	Schedule →
St Luke's Sugar Land	$0	$0	$328.5	$7,221	Schedule →
St Luke's The Vintage	$0	$0	$328.5	$7,221	Schedule →
St Luke's The Woodlands	$0	$0	$345.58	$7,221	Schedule →

Colonoscopy with Biopsy (HCPCS 45380)

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Hospital	Gross Charge	Cash Price	Low Insured	High Insured
Baylor St Luke's Medical	$0	$0	$451.58	$7,221	Schedule →
Harris Health	$3,880	$1,835.24	N/A	N/A	Schedule →
HCA Clear Lake	$0	$0	$4,255	$4,255	Schedule →
HCA Conroe	$0	$0	$450.72	$11,500	Schedule →
HCA Kingwood	$0	$0	$4,690	$4,690	Schedule →
HCA Mainland	$0	$0	$450.72	$11,500	Schedule →
HCA Medical Center	$0	$0	$4,690	$4,690	Schedule →
HCA North Cypress	$0	$0	$541.9	$3,993	Schedule →
HCA Northwest	$0	$0	$4,690	$4,690	Schedule →
HCA Pearland	$0	$0	$460.61	$4,690	Schedule →
HCA Southeast	$0	$0	$420.67	$536.58	Schedule →
HCA Tomball	$0	$0	$4,690	$4,690	Schedule →
HCA West	$0	$0	$2,434	$2,434	Schedule →
Houston Methodist	$924	$462	$1,202.09	$5,545	Schedule →
MH Cypress	$4,817	$1,541.44	$1,202.09	$2,283.98	Schedule →
MH Greater Heights	$4,588	$1,468.16	$1,202.09	$2,283.98	Schedule →
MH Katy	$4,588	$1,468.16	$1,202.09	$2,283.98	Schedule →
MH Memorial City	$4,588	$1,468.16	$1,202.09	$2,283.98	Schedule →
MH Northeast	$4,588	$1,468.16	$1,202.09	$2,283.98	Schedule →
MH Pearland	$4,588	$1,468.16	$1,202.09	$2,283.98	Schedule →
MH Southeast	$4,588	$1,468.16	$1,202.09	$2,283.98	Schedule →
MH Southwest	$4,588	$1,468.16	$1,202.09	$2,283.98	Schedule →
MH Sugar Land	$4,588	$1,468.16	$1,202.09	$2,283.98	Schedule →
Memorial Hermann TMC	$4,817	$1,541.44	$1,202.09	$2,283.98	Schedule →
MH Woodlands	$4,588	$1,468.16	$1,202.09	$2,283.98	Schedule →
St Luke's Brazosport	$0	$0	$404.46	$2,831	Schedule →
St Luke's Lakeside	$0	$0	$429.26	$7,221	Schedule →
St Luke's Patients Medica	$4,347	$1,521.45	$407.8	$7,221	Schedule →
St Luke's Springwoods Vil	$0	$0	$451.58	$7,221	Schedule →
St Luke's Sugar Land	$0	$0	$429.26	$7,221	Schedule →
St Luke's The Vintage	$0	$0	$429.26	$7,221	Schedule →
St Luke's The Woodlands	$0	$0	$451.58	$7,221	Schedule →

What These Prices Mean

Understanding the price columns: The gross charge represents the hospital's list price before any discounts. Houston Methodist shows a gross charge of $1,038 for screening colonoscopy but offers a cash price of $519, representing a 50% discount. Memorial Hermann hospitals show higher gross charges of $4,588 but provide larger percentage discounts of 68%, resulting in cash prices of $1,468.16. However, the larger discount still produces a higher final cash price due to the significantly higher starting gross charge. Patients with high-deductible insurance plans who have not met their deductible will owe the negotiated insurance rate rather than the cash price. Code variations and cost differences: Code 45378 covers for the standard screening procedure, while code 45380 includes tissue biopsy collection and processing. At Houston Methodist, the biopsy version costs $57 less in cash ($462 vs $519), while Memorial Hermann hospitals charge identical cash prices of $1,468.16 for both procedures, showing no price differentiation between the screening and biopsy versions.

Why Colonoscopy Prices Vary

Hospital pricing structures: Gross charges range from $1,038 at Houston Methodist to $4,817 at Memorial Hermann TMC, a gap of nearly $3,800. However, cash prices narrow this gap significantly, ranging from $462 to $1,541.44, a difference of about $1,080. Houston Methodist applies a 50% cash discount, while Memorial Hermann hospitals offer 68% discounts, and St. Luke's facilities provide 65% discounts. The varying discount percentages reflect different pricing philosophies and market positioning strategies among hospital systems. Facility type and alternatives: The data includes academic medical centers, community hospitals, and specialty facilities within major health systems. Academic medical centers like Houston Methodist often have different cost structures due to teaching programs and specialized services. Outpatient endoscopy centers and ambulatory surgery centers, which are not included in this hospital-focused dataset, typically charge lower facility fees for the same procedures. Cash prices in this dataset range from $462 to $1,541.44 across all Houston area hospitals reporting complete pricing data.

Paying cash? Health insurance could lower your Colonoscopy cost.

Published cash prices on this page range from $462 to $1,835.24. Insurers on this page have negotiated rates starting from $321.93, many times lower than cash prices at the same hospitals. If you are uninsured, a marketplace health plan could reduce your out-of-pocket cost for this procedure.

Compare Health Insurance Plans → Get Free Plan Estimate →

Links go to Healthcare.gov, the official federal health insurance marketplace. We are not affiliated with Healthcare.gov or any insurance provider. This is not a recommendation for any specific plan.

Compare Insurer Rates for Colonoscopy in Houston

How much does each insurance company pay for colonoscopy at Houston hospitals?

Insurer	Lowest Rate	At Hospital	Highest Rate	Hospitals
Community Health Choice	$312.07	St Luke's Patients Medical Center	$1,923.35	31
Texas Children's Health Plan	$312.07	St Luke's Patients Medical Center	$605.12	9
Amerigroup	$328.5	St Luke's Patients Medical Center	$1,771.48	14
UnitedHealthcare	$335.07	St Luke's Patients Medical Center	$2,900	20
Blue Cross Blue Shield of Texas	$344.93	St Luke's Lakeside	$2,741.52	20
Molina Healthcare	$361.35	HCA Houston Healthcare Clear Lake	$2,596.52	11
Superior Health Plan	$362.86	St Luke's Brazosport	$1,771.48	19
Humana	$410.63	HCA Houston Healthcare Clear Lake	$2,412.65	20

Rates shown are the lowest and highest negotiated rates each insurer has published across Houston hospitals for this procedure. Your actual cost depends on your plan's deductible, copay, and coinsurance.

What Insurers Actually Pay

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Published negotiated rates for Screening Colonoscopy (HCPCS 45378) at HCA Clear Lake, outpatient facility fee:

Screening Colonoscopy (45378), HCA Clear Lake Payer Rates

Insurance Payer	Plan Type	Negotiated Rate
Texas Health Network	MCD	$321.93
UTMB	MGMCD	$328.5
Amerigroup	MGMCD	$344.93
Amerigroup	MGMCD	$344.93
Amerigroup	MGMCD	$344.93
Amerigroup	MGMCD	$344.93
Amerigroup	MGMCD	$344.93
Amerigroup	MGMCD	$344.93
Amerigroup	MGMCD	$344.93
United	MGMCD	$352.49
United	MGMCD	$352.49
United	MGMCD	$352.49
United	MGMCD	$352.49
United	MGMCD	$352.49
United	MGMCD	$352.49
United	MGMCD	$352.49
United	MGMCD	$352.49
Molina Healthcare	CHIP	$361.35
Molina Healthcare	STAR	$361.35
Molina Healthcare	STARKIDS	$361.35
Molina Healthcare	STARPLUS	$361.35
Community Health Choice MCD	CHIP	$367.92
Community Health Choice MCD	CHIPPerinatal	$367.92
Community Health Choice MCD	STAR	$367.92
Community Health Choice MCD	STAR+PLUS	$367.92
Humana	MCD	$410.63
Aetna Better Health	MGMCD	$414.7
Aetna Better Health	MGMCD	$414.7
Aetna Better Health	MGMCD	$414.7
Superior Health Plan	CHIP	$948
Superior Health Plan	CHPFC	$948
Superior Health Plan	STAR	$948
Superior Health Plan	STARKids	$948
Superior Health Plan	STARPLUS	$948
Superior Health Plan	CHIP	$948
Superior Health Plan	CHPFC	$948
Superior Health Plan	STAR	$948
Superior Health Plan	STARKids	$948
Superior Health Plan	STARPLUS	$948
Superior Health Plan	CHIP	$948
Superior Health Plan	CHPFC	$948
Superior Health Plan	STAR	$948
Superior Health Plan	STARKids	$948
Superior Health Plan	STARPLUS	$948
Superior Health Plan	CHIP	$948
Superior Health Plan	CHPFC	$948
Superior Health Plan	STAR	$948
Superior Health Plan	STARKids	$948
Superior Health Plan	STARPLUS	$948
BCBS	MyBlueHealth	$1,222.21
BCBS	MyBlueHealth	$1,222.21
BCBS	MyBlueHealth	$1,222.21
BCBS	MyBlueHealth	$1,222.21
BCBS	MyBlueHealth	$1,222.21
BCBS	MyBlueHealth	$1,222.21
BCBS	MyBlueHealth	$1,222.21
BCBS	BAV	$1,382.62
BCBS	BAV	$1,382.62
BCBS	BAV	$1,382.62
BCBS	BAV	$1,382.62
BCBS	BAV	$1,382.62
BCBS	BAV	$1,382.62
BCBS	BAV	$1,382.62
Aetna	QHPExchange	$1,579
Aetna	QHPExchange	$1,579
Aetna	QHPExchange	$1,579
Aetna	QHPExchange	$1,579
Aetna	QHPExchange	$1,579
Aetna	QHPExchange	$1,579
Aetna	QHPExchange	$1,579
Aetna	QHPExchange	$1,579
BCBS	EPOSOA	$1,581.23
BCBS	HMO	$1,581.23
BCBS	PPO	$1,581.23
BCBS	EPOSOA	$1,581.23
BCBS	HMO	$1,581.23
BCBS	PPO	$1,581.23
BCBS	PPO	$1,581.23
BCBS	EPOSOA	$1,581.23
BCBS	HMO	$1,581.23
BCBS	PPO	$1,581.23
BCBS	EPOSOA	$1,581.23
BCBS	HMO	$1,581.23
BCBS	PPO	$1,581.23
BCBS	EPOSOA	$1,581.23
BCBS	HMO	$1,581.23
BCBS	PPO	$1,581.23
BCBS	EPOSOA	$1,581.23
BCBS	HMO	$1,581.23
BCBS	PPO	$1,581.23
BCBS	EPOSOA	$1,581.23
BCBS	HMO	$1,581.23
BCBS	PPO	$1,581.23
United	SmallGroup	$2,030
United	SmallGroup	$2,030
United	SmallGroup	$2,030
United	SmallGroup	$2,030
United	SmallGroup	$2,030
United	SmallGroup	$2,030
United	SmallGroup	$2,030
United	SmallGroup	$2,030
Aetna	NBHMO	$2,098
Aetna	NBPOS	$2,098
Aetna	NBHMO	$2,098
Aetna	NBPOS	$2,098
Aetna	NBHMO	$2,098
Aetna	NBPOS	$2,098
Aetna	NBHMO	$2,098
Aetna	NBPOS	$2,098
Aetna	NBHMO	$2,098
Aetna	NBPOS	$2,098
Aetna	NBHMO	$2,098
Aetna	NBPOS	$2,098
Aetna	NBHMO	$2,098
Aetna	NBPOS	$2,098
Aetna	NBHMO	$2,098
Aetna	NBPOS	$2,098
Fidelis SecureCare of TX	MGMCR	$2,115
Fidelis SecureCare of TX	MGMCR	$2,115
Fidelis SecureCare of TX	MGMCR	$2,115
Fidelis SecureCare of TX	MGMCR	$2,115
United	NarrowNetworkIndivExchange	$2,130
United	NarrowNetworkIndivExchange	$2,130
United	NarrowNetworkIndivExchange	$2,130
United	NarrowNetworkIndivExchange	$2,130
United	NarrowNetworkIndivExchange	$2,130
United	NarrowNetworkIndivExchange	$2,130
United	NarrowNetworkIndivExchange	$2,130
United	NarrowNetworkIndivExchange	$2,130
Aetna	COMMHMO	$2,229
Aetna	COMMPOS	$2,229
Aetna	COMMHMO	$2,229
Aetna	COMMPOS	$2,229
Aetna	COMMHMO	$2,229
Aetna	COMMPOS	$2,229
Aetna	COMMHMO	$2,229
Aetna	COMMPOS	$2,229
Aetna	COMMHMO	$2,229
Aetna	COMMPOS	$2,229
Aetna	COMMHMO	$2,229
Aetna	COMMPOS	$2,229
Aetna	COMMHMO	$2,229
Aetna	COMMPOS	$2,229
Aetna	COMMHMO	$2,229
Aetna	COMMPOS	$2,229
Aetna	NBPPO	$2,299
Aetna	NBPPO	$2,299
Aetna	NBPPO	$2,299
Aetna	NBPPO	$2,299
Aetna	NBPPO	$2,299
Aetna	NBPPO	$2,299
Aetna	NBPPO	$2,299
Aetna	NBPPO	$2,299
Evry Health	BroadNetwork	$2,431
Evry Health	BroadNetwork	$2,431
Evry Health	BroadNetwork	$2,431
Evry Health	BroadNetwork	$2,431
Evry Health	BroadNetwork	$2,431
Evry Health	BroadNetwork	$2,431
Evry Health	BroadNetwork	$2,431
Evry Health	BroadNetwork	$2,431
Healthcare Highways	NarrowNetwork	$2,434
Healthcare Highways	NarrowNetwork	$2,434
Healthcare Highways	NarrowNetwork	$2,434
Healthcare Highways	NarrowNetwork	$2,434
Healthcare Highways	NarrowNetwork	$2,434
Healthcare Highways	NarrowNetwork	$2,434
Healthcare Highways	NarrowNetwork	$2,434
Healthcare Highways	NarrowNetwork	$2,434
Aetna	COMMPPO	$2,444
Aetna	COMMPPO	$2,444
Aetna	COMMPPO	$2,444
Aetna	COMMPPO	$2,444
Aetna	COMMPPO	$2,444
Aetna	COMMPPO	$2,444
Aetna	COMMPPO	$2,444
Aetna	COMMPPO	$2,444
Curative Administrators	COMM	$2,613
Curative Administrators	COMM	$2,613
Curative Administrators	COMM	$2,613
Curative Administrators	COMM	$2,613
Curative Administrators	COMM	$2,613
Curative Administrators	COMM	$2,613
Curative Administrators	COMM	$2,613
Curative Administrators	COMM	$2,613
Aetna	OONHMO	$2,623
Aetna	OONPOS	$2,623
Aetna	OONHMO	$2,623
Aetna	OONPOS	$2,623
Aetna	OONHMO	$2,623
Aetna	OONPOS	$2,623
Aetna	OONHMO	$2,623
Aetna	OONPOS	$2,623
Aetna	OONHMO	$2,623
Aetna	OONPOS	$2,623
Aetna	OONHMO	$2,623
Aetna	OONPOS	$2,623
Aetna	OONHMO	$2,623
Aetna	OONPOS	$2,623
Aetna	OONHMO	$2,623
Aetna	OONPOS	$2,623
Aetna	ASAHMO	$2,832
Aetna	ASAPOS	$2,832
Aetna	ASAHMO	$2,832
Aetna	ASAPOS	$2,832
Aetna	ASAHMO	$2,832
Aetna	ASAPOS	$2,832
Aetna	ASAHMO	$2,832
Aetna	ASAPOS	$2,832
Aetna	ASAHMO	$2,832
Aetna	ASAPOS	$2,832
Aetna	ASAHMO	$2,832
Aetna	ASAPOS	$2,832
Aetna	ASAHMO	$2,832
Aetna	ASAPOS	$2,832
Aetna	ASAHMO	$2,832
Aetna	ASAPOS	$2,832
Aetna	OONPPO	$2,876
Aetna	OONPPO	$2,876
Aetna	OONPPO	$2,876
Aetna	OONPPO	$2,876
Aetna	OONPPO	$2,876
Aetna	OONPPO	$2,876
Aetna	OONPPO	$2,876
Aetna	OONPPO	$2,876
United	AllPayerAppendix	$2,900
United	AllPayerAppendix	$2,900
United	AllPayerAppendix	$2,900
United	AllPayerAppendix	$2,900
United	AllPayerAppendix	$2,900
United	AllPayerAppendix	$2,900
United	AllPayerAppendix	$2,900
United	AllPayerAppendix	$2,900
Cigna	CSN	$2,915
Cigna	CSN	$2,915
Cigna	CSN	$2,915
Cigna	CSN	$2,915
Cigna	CSN	$2,915
Cigna	CSN	$2,915
Cigna	CSN	$2,915
Oscar	HIX	$2,979
Oscar	HIX	$2,979
Oscar	HIX	$2,979
Oscar	HIX	$2,979
Oscar	HIX	$2,979
Oscar	HIX	$2,979
Oscar	HIX	$2,979
Oscar	HIX	$2,979
Aetna	ASAPPO	$3,106
Aetna	ASAPPO	$3,106
Aetna	ASAPPO	$3,106
Aetna	ASAPPO	$3,106
Aetna	ASAPPO	$3,106
Aetna	ASAPPO	$3,106
Aetna	ASAPPO	$3,106
Aetna	ASAPPO	$3,106
Cigna	OpenAccessPlus	$3,158
Cigna	OpenAccessPlus	$3,158
Cigna	OpenAccessPlus	$3,158
Cigna	OpenAccessPlus	$3,158
Cigna	OpenAccessPlus	$3,158
Cigna	OpenAccessPlus	$3,158
Cigna	OpenAccessPlus	$3,158
Cigna	PPO	$3,755
Cigna	PPO	$3,755
Cigna	PPO	$3,755
Cigna	PPO	$3,755
Cigna	PPO	$3,755
Cigna	PPO	$3,755
Cigna	PPO	$3,755
Kelsey Care (Boon-Chapman)	COMM	$4,255
Kelsey Care (Boon-Chapman)	COMM	$4,255
Kelsey Care (Boon-Chapman)	COMM	$4,255
Kelsey Care (Boon-Chapman)	COMM	$4,255
Kelsey Care (Boon-Chapman)	COMM	$4,255
Kelsey Care (Boon-Chapman)	COMM	$4,255
Kelsey Care (Boon-Chapman)	COMM	$4,255
Kelsey Care (Boon-Chapman)	COMM	$4,255
Humana	HMO	$4,690
Humana	PPO	$4,690
Humana	HMO	$4,690
Humana	PPO	$4,690
Humana	HMO	$4,690
Humana	PPO	$4,690
Humana	HMO	$4,690
Humana	PPO	$4,690
Humana	HMO	$4,690
Humana	PPO	$4,690
Humana	HMO	$4,690
Humana	PPO	$4,690
Humana	HMO	$4,690
Humana	PPO	$4,690
Humana	HMO	$4,690
Humana	PPO	$4,690
Humana	HMO	$4,690
Humana	PPO	$4,690
Humana	HMO	$4,690
Humana	PPO	$4,690
Multiplan	SAVILITYNETWORK	$5,350
Multiplan	SAVILITYNETWORK	$5,350
Multiplan	SAVILITYNETWORK	$5,350
Multiplan	SAVILITYNETWORK	$5,350
Multiplan	SAVILITYNETWORK	$5,350
Multiplan	SAVILITYNETWORK	$5,350
Multiplan	SAVILITYNETWORK	$5,350
Multiplan	SAVILITYNETWORK	$5,350
Multiplan	PRIMARYPPO	$11,500
Multiplan	PRIMARYPPO	$11,500
Multiplan	PRIMARYPPO	$11,500
Multiplan	PRIMARYPPO	$11,500
Multiplan	PRIMARYPPO	$11,500
Multiplan	PRIMARYPPO	$11,500
Multiplan	PRIMARYPPO	$11,500
Multiplan	PRIMARYPPO	$11,500

Key finding: Multiplan PRIMARYPPO insurance rates vary dramatically, paying as little as $312.07 for some plans while reaching $11,500 for others at the same hospitals.

How to Use This Information

✓ These are facility fees only. The physician's fee is billed separately.
✓ Contact your insurer or the hospital billing department for your specific out-of-pocket cost.
✓ Many hospitals offer financial assistance programs for patients who qualify.

Our methodology · Medical Disclaimer

What Patients Ask About Colonoscopy Costs

How much does a colonoscopy cost without insurance in Houston?

Cash prices for colonoscopy without insurance in Houston range from $462 to $1,541.44, depending on the hospital and procedure type. Houston Methodist charges $519 for screening colonoscopy and $462 for colonoscopy with biopsy. Memorial Hermann hospitals charge $1,468.16 for most locations, while Memorial Hermann TMC and Cypress charge $1,541.44. St. Luke's facilities charge $1,375.92 for screening and $1,521.45 for biopsy procedures. Many hospitals in the dataset show incomplete cash pricing data with $0 amounts, but their insured rate ranges suggest similar pricing tiers. These facility fees cover only the hospital's services and do not include physician fees, anesthesia services, or pathology fees, which are billed separately by the respective medical professionals.

Why is the gross charge so much higher than the cash price?

The gross charge represents the hospital's published list price before any discounts, but almost no one pays this amount. Houston Methodist's gross charge of $1,038 becomes a $519 cash price with a 50% discount. Memorial Hermann hospitals start with gross charges of $4,588 but apply 68% discounts, resulting in $1,468.16 cash prices. Interestingly, Memorial Hermann's larger percentage discount still produces higher final cash prices because their gross charges are significantly higher to begin with. The gross charge, also called the chargemaster price, serves as the starting point for all other pricing negotiations with insurance companies. These inflated list prices have little relation to actual costs or what patients typically pay, whether through insurance or cash arrangements.

Does insurance cover a colonoscopy?

Insurance coverage for colonoscopy depends on your specific plan benefits and your plan's coverage criteria. Insured rates in Houston range from $312.07 to $11,500, showing dramatic variation even within the same insurance company's different plan types. Most insurance plans cover colonoscopy but screening procedures may have different coverage rules than diagnostic ones. Many insurers require prior authorization for non-emergency colonoscopies, and Patients may verify coverage before scheduling. Patients with high-deductible health plans who have not yet met their annual deductible will pay the negotiated insurance rate out-of-pocket, not the higher gross charge. The negotiated rates are typically much lower than both gross charges and cash prices.

Are there additional fees beyond the colonoscopy facility charge?

The hospital facility fee covers only the room, equipment, nursing staff, and sedation services. The performing gastroenterologist bills separately for professional services, and an anesthesiologist may bill separately if deeper sedation is used beyond basic conscious sedation. If tissue samples are collected during the procedure, pathology services for analyzing the specimens are billed separately by the pathology laboratory. These professional fees are not included in the hospital's facility charges and can add significant cost to the total procedure. If complications arise requiring additional interventions or extended recovery time, additional facility and professional fees may apply. Patients may request estimates for all components of care, not just the hospital facility fee, to understand their total potential financial responsibility.

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Baylor St Luke's Medical Center

File updated: 2026-02-28 · Accessed by us: 2026-04-13

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