Colonoscopy Cost in Orlando, FL

How much does a colonoscopy cost without insurance in Orlando?

Cash prices are available for only some hospitals. UF Health Leesburg and The Villages list $2,483.25 for screening (45378) and $2,320.45 for biopsy (45380). AdventHealth Orlando lists $2,996 and $3,914. AdventHealth Waterman lists $4,939.82 for biopsy; its screening cash price is $0, and the HCA Florida hospitals and UCF Lake Nona also list $0, which appears to be incomplete data. Insured rates at those hospitals range from $971.14 to $12,500 for context. Where cash prices exist, they run from $2,320.45 to $4,939.82. These are facility fees; physician and professional fees are billed separately.

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

The gross charge, or chargemaster price, is a hospital's full list price for a service. Almost no one pays it, because insurers negotiate lower rates and hospitals discount for cash payers. At UF Health, cash prices are 55% of gross, such as $2,483.25 against $4,515 for code 45378. AdventHealth Orlando's cash price equals its gross charge, $2,996 for the same code. UF Health's larger percentage discount still leaves a cash price below that of AdventHealth Orlando, but its list price starts higher, so the gap between the two cash prices is much smaller than the gap between their gross charges.

Does insurance cover a colonoscopy?

Many insurance plans cover colonoscopy, but coverage depends on the specific plan and on medical necessity criteria. Negotiated rates vary widely: for code 45378, the 516 payer rates in the data run from $636.88 for Humana and Simply Healthcare managed Medicaid plans at UF Health to $12,500 for an Ultimate Health Plan Medicare Advantage product at several hospitals. Prior authorization requirements apply to some non-emergency procedures and differ by insurer. If you have a high-deductible plan and have not met your deductible, you owe the negotiated rate for the service, not the gross charge, until the deductible is met.

Are there additional fees beyond the colonoscopy facility charge?

Yes. The facility fee covers the hospital's room, equipment, and staff. A colonoscopy is typically a procedural service, so the physician performing it bills a separate professional fee. Anesthesia services, when used, are billed separately by the anesthesiologist or anesthesia group. When a biopsy is taken, a pathologist's laboratory examination of the tissue is also billed separately from the facility fee. Procedures performed in an emergency department incur separate ER facility fees. These additional charges are not included in the facility prices shown in the hospital transparency files, and no dollar amounts for them appear in this data.

What is the cash price for a colonoscopy at UF Health Leesburg Hospital?

UF Health Leesburg Hospital publishes a cash price of $2,483.25 for Screening Colonoscopy (45378) and $2,320.45 for Colonoscopy with Biopsy (45380). Both are facility charges only and equal 55% of the listed gross charge. Professional fees are not included in these figures.

What is the lowest and highest published colonoscopy cash price in Orlando?

Across the Orlando-area hospitals on this page, cash prices run from $2,320.45 at UF Health Leesburg Hospital (45380) to $4,939.82 at AdventHealth Waterman (45380). These are facility charges only. Only 7 of 18 price rows have a published cash price, and a $0 or blank entry means missing data, not free.

Which Orlando hospitals don't publish a cash price for colonoscopy?

Five hospitals on this page list no cash price for any colonoscopy code: HCA Florida Lake Monroe Hospital, HCA Florida Osceola Hospital, HCA Florida Oviedo Medical Center, HCA Florida Poinciana Hospital, and UCF Lake Nona Hospital. Their cash and gross fields are $0 or blank, which means missing data, not free.

What does Florida Blue pay for a colonoscopy in Orlando hospitals?

Florida Blue's published facility rates on this page start at $971.14 at AdventHealth Orlando and reach $6,205 at UCF Lake Nona Hospital, with a median of $3,085 across 9 hospitals. The highest is about 6x the lowest. These are facility rates only and do not include other billed services.

How much do insured colonoscopy rates vary at HCA Florida Osceola Hospital?

For Screening Colonoscopy (45378), HCA Florida Osceola Hospital lists 97 published payer rates. They range from $1,228.07 for CorVel Corporation workers' comp to $12,500 for Ultimate Health Plan, about 10x the lowest. Its cash price is not published, shown as $0 or blank, which means missing, not free.