Diagnostic exam of large bowel using a flexible endoscope
Medicare pricing data for 23,805 providers across 52 states
This procedure has a 5.8x markup — hospitals charge $1,373 but Medicare allows only $237.69. Uninsured patients may face bills 5.8 times higher than what insurance negotiates. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Diagnostic exam of large bowel using a flexible endoscope (HCPCS code 45378) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $237.69, but hospitals typically charge $1,373 — a 5.8x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $237.69, your out-of-pocket cost would be approximately $47.54. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 5.8x more than what Medicare allows for this procedure. Medicare actually pays $182.70 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $333 | $2,577 | 73 | 988 | +40.0% |
| Puerto Rico | $287 | $370 | 144 | 680 | +20.8% |
| Nevada | $285 | $2,251 | 129 | 3,464 | +20.0% |
| New York | $284 | $1,784 | 1,961 | 29,886 | +19.7% |
| California | $275 | $1,710 | 1,984 | 32,131 | +15.5% |
| Hawaii | $274 | $1,547 | 79 | 1,002 | +15.1% |
| New Jersey | $266 | $2,101 | 758 | 12,405 | +11.7% |
| Maryland | $261 | $1,056 | 478 | 9,853 | +9.7% |
| Delaware | $258 | $1,197 | 94 | 2,041 | +8.6% |
| Arizona | $256 | $1,272 | 452 | 6,503 | +7.5% |
| Florida | $248 | $1,407 | 1,592 | 25,809 | +4.4% |
| Rhode Island | $244 | $1,309 | 80 | 1,217 | +2.8% |
| Connecticut | $240 | $1,440 | 307 | 3,153 | +1.0% |
| Colorado | $236 | $1,715 | 371 | 3,456 | -0.7% |
| Wyoming | $235 | $1,564 | 53 | 551 | -1.0% |
| Oregon | $235 | $1,185 | 304 | 2,486 | -1.1% |
| Georgia | $232 | $1,174 | 671 | 10,134 | -2.4% |
| Washington | $232 | $895 | 483 | 4,367 | -2.4% |
| North Carolina | $232 | $1,103 | 763 | 9,888 | -2.5% |
| South Carolina | $231 | $1,152 | 378 | 7,748 | -2.7% |
| Texas | $230 | $1,709 | 1,627 | 19,501 | -3.4% |
| Pennsylvania | $225 | $1,042 | 1,184 | 13,129 | -5.2% |
| Mississippi | $225 | $1,339 | 162 | 4,200 | -5.5% |
| Illinois | $222 | $1,472 | 947 | 12,436 | -6.6% |
| Virginia | $220 | $1,074 | 646 | 7,374 | -7.5% |
| Louisiana | $220 | $999 | 333 | 4,616 | -7.6% |
| South Dakota | $219 | $1,002 | 77 | 1,248 | -7.8% |
| Arkansas | $219 | $910 | 214 | 4,098 | -8.0% |
| Tennessee | $218 | $1,123 | 468 | 8,651 | -8.4% |
| New Hampshire | $216 | $1,660 | 115 | 1,654 | -8.9% |
| Nebraska | $213 | $1,076 | 167 | 1,848 | -10.4% |
| Ohio | $213 | $966 | 998 | 11,778 | -10.5% |
| Utah | $213 | $1,492 | 156 | 1,757 | -10.5% |
| Michigan | $212 | $828 | 793 | 7,859 | -10.6% |
| New Mexico | $212 | $1,050 | 95 | 1,400 | -10.9% |
| Iowa | $212 | $1,315 | 223 | 2,325 | -11.0% |
| Kansas | $211 | $1,160 | 251 | 4,119 | -11.3% |
| District of Columbia | $210 | $949 | 80 | 757 | -11.5% |
| Idaho | $208 | $735 | 106 | 1,154 | -12.3% |
| Oklahoma | $208 | $844 | 256 | 3,793 | -12.4% |
| Massachusetts | $206 | $1,111 | 647 | 7,802 | -13.3% |
| Alabama | $204 | $1,087 | 360 | 6,024 | -14.0% |
| Missouri | $204 | $1,255 | 492 | 6,194 | -14.1% |
| Indiana | $201 | $1,443 | 494 | 5,489 | -15.6% |
| Vermont | $197 | $1,254 | 42 | 389 | -17.1% |
| Montana | $195 | $758 | 59 | 830 | -18.1% |
| Minnesota | $192 | $1,153 | 486 | 2,857 | -19.2% |
| Kentucky | $186 | $919 | 366 | 4,625 | -21.7% |
| Wisconsin | $184 | $2,243 | 456 | 3,306 | -22.7% |
| Maine | $178 | $788 | 92 | 796 | -25.2% |
| West Virginia | $175 | $864 | 144 | 1,834 | -26.2% |
| North Dakota | $172 | $1,046 | 68 | 761 | -27.5% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
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