Colorectal cancer screening; colonoscopy on individual at high risk
Medicare pricing data for 20,101 providers across 52 states
This procedure has a 5.4x markup — hospitals charge $1,445 but Medicare allows only $265.12. Uninsured patients may face bills 5.4 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
Colorectal cancer screening; colonoscopy on individual at high risk (HCPCS code G0105) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $265.12, but hospitals typically charge $1,445 — a 5.4x 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 $265.12, your out-of-pocket cost would be approximately $53.02. 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 5.4x more than what Medicare allows for this procedure. Medicare actually pays $265.12 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| California | $331 | $2,025 | 1,443 | 30,929 | +24.8% |
| Puerto Rico | $329 | $373 | 11 | 18 | +24.3% |
| Alaska | $317 | $2,315 | 51 | 877 | +19.7% |
| New Jersey | $309 | $2,422 | 624 | 13,334 | +16.5% |
| Maryland | $296 | $1,119 | 400 | 13,478 | +11.5% |
| Nevada | $294 | $2,234 | 102 | 2,180 | +11.0% |
| Delaware | $293 | $1,390 | 80 | 3,176 | +10.6% |
| New York | $290 | $1,626 | 1,123 | 15,736 | +9.5% |
| Rhode Island | $288 | $1,533 | 82 | 1,560 | +8.6% |
| Colorado | $284 | $2,355 | 319 | 7,908 | +7.2% |
| Oregon | $281 | $1,351 | 294 | 4,936 | +6.0% |
| Connecticut | $276 | $1,554 | 283 | 4,346 | +4.1% |
| Washington | $276 | $950 | 473 | 8,953 | +4.0% |
| Florida | $273 | $1,478 | 1,364 | 39,300 | +3.1% |
| Arizona | $270 | $1,341 | 396 | 11,926 | +1.8% |
| North Carolina | $266 | $1,126 | 678 | 16,601 | +0.2% |
| Georgia | $265 | $1,165 | 574 | 13,953 | +0.1% |
| Texas | $264 | $1,994 | 1,355 | 29,533 | -0.5% |
| Hawaii | $262 | $1,506 | 42 | 517 | -1.2% |
| Pennsylvania | $261 | $1,124 | 1,132 | 25,353 | -1.4% |
| Wyoming | $260 | $1,463 | 46 | 899 | -2.1% |
| South Carolina | $257 | $1,115 | 342 | 11,221 | -3.2% |
| New Mexico | $256 | $1,042 | 87 | 1,848 | -3.4% |
| Kansas | $255 | $1,407 | 228 | 5,301 | -3.9% |
| Nebraska | $254 | $1,122 | 177 | 3,436 | -4.0% |
| Louisiana | $252 | $1,004 | 304 | 7,521 | -4.8% |
| Massachusetts | $252 | $1,246 | 625 | 14,649 | -5.1% |
| Utah | $251 | $2,017 | 140 | 2,748 | -5.4% |
| Illinois | $250 | $1,617 | 765 | 13,560 | -5.6% |
| Mississippi | $250 | $1,238 | 142 | 6,209 | -5.8% |
| Michigan | $249 | $895 | 743 | 11,908 | -6.2% |
| Ohio | $247 | $1,002 | 910 | 15,031 | -6.8% |
| Indiana | $244 | $1,972 | 471 | 9,755 | -8.0% |
| Tennessee | $243 | $1,316 | 428 | 11,624 | -8.2% |
| Arkansas | $243 | $961 | 184 | 4,836 | -8.5% |
| Idaho | $237 | $773 | 122 | 2,139 | -10.7% |
| Virginia | $236 | $1,059 | 557 | 10,592 | -11.0% |
| Missouri | $233 | $1,338 | 448 | 8,441 | -12.0% |
| Alabama | $230 | $1,136 | 257 | 5,013 | -13.2% |
| Minnesota | $230 | $1,171 | 494 | 4,907 | -13.4% |
| Iowa | $230 | $1,386 | 221 | 4,637 | -13.4% |
| District of Columbia | $228 | $742 | 56 | 794 | -13.9% |
| New Hampshire | $228 | $1,811 | 100 | 2,561 | -14.0% |
| Oklahoma | $228 | $817 | 213 | 4,250 | -14.1% |
| Kentucky | $226 | $978 | 321 | 6,180 | -14.7% |
| Wisconsin | $214 | $2,402 | 441 | 6,207 | -19.1% |
| Maine | $212 | $912 | 80 | 1,062 | -20.0% |
| South Dakota | $211 | $968 | 85 | 1,553 | -20.6% |
| Vermont | $209 | $1,221 | 36 | 764 | -21.0% |
| Montana | $206 | $707 | 55 | 1,154 | -22.4% |
| North Dakota | $206 | $1,225 | 65 | 1,134 | -22.5% |
| West Virginia | $189 | $707 | 104 | 1,228 | -28.6% |
⚠️ 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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