Colonoscopy Cost in Lakeland-Winter Haven, FL

A colonoscopy is a procedure in which a clinician guides a long, flexible tube with a camera and light, called a colonoscope, through the rectum and along the length of the large intestine. The camera transmits live images to a monitor, and small tools can pass through the scope to collect tissue samples. The facility fee covers the hospital's procedure room, endoscopy equipment, nursing and support staff, and recovery area. Prices on this page come from CMS-mandated hospital price transparency files. Two billing codes are covered here: HCPCS 45378 (Screening Colonoscopy) and HCPCS 45380 (Colonoscopy with Biopsy).

Data last accessed by us: 2026-10-15 · Newest hospital file date among hospitals below: 2026-04-01

Data may be outdated

This hospital's pricing file has not been updated since 12/31/2025 (288 days ago). Prices may not reflect current charges. Contact the hospital directly for current pricing.

Incomplete rows: Some hospitals publish $0 / blank amounts for this procedure in their transparency file. Those cells show as N/A and are excluded from the cash range above.

Screening Colonoscopy (HCPCS 45378)

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Hospital	Gross Charge	Cash Price	Low Insured	High Insured
AdventHealth Heart of Florida	N/A	N/A	$971.14	$2,155.92	Schedule →
AdventHealth Lake Wales	N/A	N/A	$971.14	$2,155.92	Schedule →

Colonoscopy with Biopsy (HCPCS 45380)

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Hospital	Gross Charge	Cash Price	Low Insured	High Insured
AdventHealth Heart of Florida	N/A	N/A	$1,249.63	$2,774.17	Schedule →
AdventHealth Lake Wales	N/A	N/A	$1,249.63	$2,774.17	Schedule →

What These Prices Mean

Understanding the price columns
A gross charge is the hospital's full list price, also called the chargemaster rate. A cash price is the amount offered to patients paying without insurance. The insured range shows the lowest and highest negotiated rates between the hospital and insurers. For both AdventHealth Heart of Florida and AdventHealth Lake Wales, the gross and cash prices are listed as $0 for both codes. That indicates incomplete data, not a real price, so the insured range is the usable reference: $971.14 to $2,155.92 for code 45378 and $1,249.63 to $2,774.17 for code 45380. Patients on high-deductible plans who have not yet met their deductible owe the negotiated rate, not the gross charge.

Code variations
Code 45378 describes a colonoscopy examining the colon without tissue removal. Code 45380 describes the same examination with one or more biopsies, meaning small tissue samples are collected. The added work raises the facility rate. At both AdventHealth hospitals, the lowest insured rate rises from $971.14 to $1,249.63, a difference of $278.49. The highest rises from $2,155.92 to $2,774.17, a difference of $618.25.

Why Colonoscopy Prices Vary

Hospital pricing structures
The two AdventHealth hospitals in this dataset report identical insured ranges for each code, so no gap appears between them in negotiated rates. Their gross charge and cash price fields are both $0, so gross and cash gaps cannot be calculated, and the cash-to-gross ratios are unavailable. Differences in negotiated rates still appear across other facilities in the payer data. For code 45378, rates run from $915.15 at Bartow Regional Medical Center and Winter Haven Hospital (several Medicare Advantage plans) up to $2,333.64 at Winter Haven Hospital (Ambetter Commercial Value), roughly a threefold spread.

Facility type and alternatives
Hospital outpatient departments, academic medical centers, and community hospitals can each negotiate different rates with insurers, and those rates reflect contract terms, not necessarily the care delivered. Outpatient or freestanding endoscopy centers are not in this dataset and may charge differently. Because the cash price data for the two hospitals shown here is missing, no verified cash price range is available, and the insured rates serve as the available reference.

Paying cash? Health insurance could lower your Colonoscopy cost.

Published cash prices on this page range from N/A to N/A. The lowest insured rate in the price table is $971.14 (AdventHealth Heart of Florida). Insured rates depend on the plan, and the lowest are often Medicaid, CHIP or Medicare Advantage plans, so they may not reflect what a commercial or marketplace plan pays. 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.

What Insurers Actually Pay

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Published negotiated rates for Screening Colonoscopy (HCPCS 45378) at Winter Haven Hospital, outpatient facility fee:

Screening Colonoscopy (45378), Winter Haven Hospital Payer Rates

Insurance Payer	Plan Type	Negotiated Rate
Aetna	Medicare PPO	$915.15
BayCarePlus	Medicare HMO	$915.15
Blue Cross	Medicare HMO	$915.15
CarePlus	Medicare HMO	$938.94
Humana Military	Commercial Other	$950.73
United Healthcare	Medicare HMO	$979.22
Solis Health	Medicare HMO	$1,006.67
Freedom	Medicare HMO	$1,009.61
Optimum	Medicare HMO	$1,009.61
Aetna	Medicare HMO	$1,052.43
Cigna	Medicare HMO	$1,052.43
Health First	Medicare HMO	$1,052.43
Humana	Medicare HMO	$1,143.94
Wellcare	Medicare HMO	$1,281.22
United Healthcare	Commercial HMO	$1,370
Ambetter	Commercial Select Core	$2,059.10
Ambetter	Commercial Value	$2,333.64

Key finding: For code 45378, the lowest rate is $915.15 (several Medicare Advantage plans) while Ambetter Commercial Value at Winter Haven Hospital pays $2,333.64, roughly 2.5 times higher.

What to Do With These Colonoscopy Prices

Gaps first, because they change the call. Neither AdventHealth Heart of Florida nor AdventHealth Lake Wales publishes a cash price for either code here, and the gross charge shows N/A for all 4 rows. Those blanks mean the data is missing, not that the service is free. Ask each hospital directly for a cash or self-pay price.

Biopsy changes the code, so ask about both. A screening colonoscopy is billed under 45378. If tissue is removed for testing, which is decided during the procedure, it becomes 45380. Ask for an itemized estimate under both codes, and ask your insurer how a biopsy changes your share.

Use the insured range as a ruler. The facility figures on this page run from $971.14 to $2,155.92 for 45378 and from $1,249.63 to $2,774.17 for 45380. Once you have a cash quote, you can set it next to the matching range. No cash prices are published here, so there is nothing on this page to compare it against directly.

Match each bill to its sender. The figures above are facility charges only. Expect separate bills, and check each one for who sent it:

The hospital or surgery center, for the facility fee.
The physician who performs the exam, for the professional fee.
The anesthesia provider, billed on its own.
The lab that reads any tissue sample, if one is taken.

You can ask the hospital whether its estimate includes any of these or only the facility portion.

Financial assistance and discounts. Nonprofit hospitals are required to publish a financial assistance policy, and the billing office can send it with an application. Some hospitals also offer prompt-pay or self-pay discounts; these vary by hospital and are not included in this data. If you are uninsured or not using insurance for scheduled care, you can ask the provider for a good faith estimate before the appointment.

General information about using published prices, not medical, legal or financial advice. Confirm your own cost with the hospital and your insurer. Our methodology · Medical Disclaimer

What Patients Ask About Colonoscopy Costs

How much does a colonoscopy cost without insurance in Lakeland-Winter Haven?

The cash prices listed for both AdventHealth Heart of Florida and AdventHealth Lake Wales are $0 for codes 45378 and 45380. That appears to be incomplete data, not a real price. For context, insured rates range from $971.14 to $2,155.92 for a screening colonoscopy (45378) and $1,249.63 to $2,774.17 for a colonoscopy with biopsy (45380). The biopsy variant runs $278.49 to $618.25 higher at the same hospitals. These figures are facility fees, covering the room, equipment, and staff. Physician and professional fees are billed separately.

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

A gross charge is the hospital's full list price, known as the chargemaster rate, and almost no one pays it. Insurers negotiate lower rates, and uninsured patients are typically offered a discounted cash price. For both AdventHealth Heart of Florida and AdventHealth Lake Wales, the gross and cash fields are listed as $0, so the cash-to-gross ratio cannot be calculated. That points to incomplete reporting, not a free procedure. Insured rates of $971.14 to $2,774.17 across the two codes offer a more realistic picture of what these hospitals receive for the service.

Does insurance cover a colonoscopy?

Coverage depends on your specific plan and on whether the procedure meets the plan's medical necessity criteria. Many plans require prior authorization for non-emergency procedures. Negotiated rates vary widely: for code 45378, they range from $915.15 to $2,333.64, and for code 45380, from $1,183.54 to $3,018.02, depending on the insurer and facility. If you have a high-deductible plan and have not met your deductible, you owe the negotiated rate, not the gross charge, until the deductible is satisfied. Your insurer can confirm what your plan covers.

Are there additional fees beyond the colonoscopy facility charge?

Yes. The facility fee covers the hospital's room, equipment, and staff, but other services are billed separately. The physician who performs the procedure bills a professional fee. Anesthesia services, when used, are billed by the anesthesiologist or anesthesia group. If a biopsy is taken, a pathologist's laboratory fee for examining the tissue is billed separately as well. These charges are not in the source data, so no dollar amounts are given. A procedure performed in an emergency department also incurs a separate ER facility fee.

What is the cash price for a colonoscopy at AdventHealth Heart of Florida?

AdventHealth Heart of Florida has no published cash price for either code on this page, 45378 or 45380. The cash and gross charge fields were published as $0 or blank, which means the data is missing, not free. Only insured rates are listed, and all figures are facility charges only.

What is the lowest and highest insured colonoscopy price in Lakeland-Winter Haven?

The lowest insured rate on this page is $971.14 for code 45378 at AdventHealth Heart of Florida. The highest is $2,774.17 for code 45380 at the same hospital. These are facility charges only. They do not include physician, anesthesia, or pathology billing, and no cash prices are published.

How much does Aetna pay for a colonoscopy in Winter Haven?

For Screening Colonoscopy (45378) at Winter Haven Hospital, the Aetna Medicare PPO rate is $915.15. Across the 4 hospitals in the Aetna comparison, rates run from $915.15 at Bartow Regional Medical Center to $1,337.10 at AdventHealth Heart of Florida, with a median of $1,117.99. These are facility charges only.

What is the difference between CPT 45378 and 45380 colonoscopy prices?

Code 45378 is Screening Colonoscopy and code 45380 is Colonoscopy with Biopsy. At AdventHealth Heart of Florida, insured rates for 45378 run from $971.14 to $2,155.92, while 45380 runs from $1,249.63 to $2,774.17. AdventHealth Lake Wales lists the same ranges. Figures are facility charges only.

How much do Winter Haven Hospital colonoscopy prices vary by insurer?

Winter Haven Hospital published 17 rates for Screening Colonoscopy (45378). They run from $915.15 for Aetna Medicare PPO, BayCarePlus Medicare HMO, and Blue Cross Medicare HMO to $2,333.64 for Ambetter Commercial Value. The highest is about 3x the lowest. These are facility charges only, and no cash price is shown.

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Data Sources

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Hospital CMS transparency files typically range from tens of megabytes to several hundred megabytes. Clicking a link below will open the file in a new tab and may trigger a large download, which can consume mobile data or slow down older devices. These files are intended for data processing, not casual viewing.

AdventHealth Heart of Florida

File updated: 2026-04-01 · Accessed by us: 2026-10-15

Attested by: Tim Reiner

We are not affiliated with AdventHealth Heart of Florida. Published prices may not reflect your actual cost. Disclaimer

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