Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
Medicare pricing data for 21,348 providers across 52 states
This procedure has a 5.7x markup — hospitals charge $1,505 but Medicare allows only $262.36. Uninsured patients may face bills 5.7 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 not meeting criteria for high risk (HCPCS code G0121) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $262.36, but hospitals typically charge $1,505 — a 5.7x 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 $262.36, your out-of-pocket cost would be approximately $52.47. 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 5.7x more than what Medicare allows for this procedure. Medicare actually pays $262.36 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| California | $323 | $2,015 | 1,677 | 30,360 | +22.9% |
| Alaska | $310 | $2,366 | 58 | 980 | +18.3% |
| New York | $310 | $1,995 | 1,240 | 12,918 | +18.0% |
| New Jersey | $309 | $2,532 | 673 | 11,689 | +17.7% |
| Hawaii | $291 | $1,598 | 57 | 503 | +10.9% |
| Nevada | $288 | $1,870 | 115 | 2,446 | +9.7% |
| Maryland | $286 | $1,028 | 427 | 9,880 | +8.9% |
| Colorado | $278 | $2,205 | 326 | 5,449 | +6.0% |
| Wyoming | $277 | $1,421 | 52 | 1,042 | +5.6% |
| Arizona | $274 | $1,654 | 416 | 7,874 | +4.6% |
| Florida | $272 | $1,556 | 1,474 | 25,752 | +3.6% |
| Rhode Island | $270 | $1,414 | 75 | 787 | +2.9% |
| Delaware | $269 | $1,275 | 92 | 1,885 | +2.6% |
| Connecticut | $267 | $1,621 | 277 | 2,698 | +1.6% |
| Washington | $266 | $973 | 456 | 5,238 | +1.5% |
| Oregon | $264 | $1,307 | 291 | 3,130 | +0.6% |
| North Carolina | $261 | $1,092 | 684 | 9,425 | -0.7% |
| Texas | $258 | $1,890 | 1,523 | 23,543 | -1.7% |
| Georgia | $258 | $1,170 | 606 | 9,065 | -1.7% |
| Puerto Rico | $256 | $532 | 16 | 36 | -2.3% |
| Pennsylvania | $253 | $1,131 | 1,148 | 14,523 | -3.5% |
| Massachusetts | $246 | $1,255 | 585 | 7,423 | -6.3% |
| South Carolina | $246 | $1,176 | 350 | 6,884 | -6.4% |
| Nebraska | $245 | $1,114 | 194 | 2,488 | -6.6% |
| Mississippi | $244 | $1,270 | 154 | 4,112 | -7.0% |
| Illinois | $244 | $1,567 | 796 | 9,026 | -7.2% |
| Louisiana | $242 | $999 | 338 | 5,264 | -8.0% |
| New Mexico | $241 | $1,084 | 97 | 1,525 | -8.0% |
| Virginia | $241 | $1,282 | 567 | 6,895 | -8.1% |
| Michigan | $241 | $930 | 774 | 8,848 | -8.2% |
| Utah | $241 | $1,586 | 167 | 2,859 | -8.2% |
| Tennessee | $241 | $1,490 | 439 | 7,302 | -8.3% |
| Kansas | $240 | $1,387 | 257 | 4,484 | -8.6% |
| Missouri | $233 | $1,493 | 481 | 6,105 | -11.2% |
| Ohio | $232 | $1,064 | 967 | 11,586 | -11.5% |
| Iowa | $232 | $1,367 | 219 | 3,180 | -11.5% |
| Indiana | $230 | $1,873 | 497 | 5,981 | -12.5% |
| New Hampshire | $229 | $1,689 | 102 | 1,535 | -12.6% |
| Idaho | $229 | $717 | 137 | 1,734 | -12.6% |
| Minnesota | $227 | $1,207 | 484 | 3,258 | -13.6% |
| Montana | $225 | $779 | 58 | 1,321 | -14.1% |
| Oklahoma | $224 | $770 | 237 | 4,451 | -14.5% |
| Alabama | $221 | $1,075 | 300 | 2,992 | -15.8% |
| Arkansas | $219 | $867 | 200 | 3,345 | -16.4% |
| District of Columbia | $218 | $715 | 72 | 630 | -16.9% |
| Kentucky | $212 | $1,036 | 337 | 3,850 | -19.3% |
| Maine | $211 | $946 | 79 | 646 | -19.4% |
| Wisconsin | $211 | $2,355 | 441 | 4,221 | -19.5% |
| South Dakota | $210 | $939 | 87 | 1,081 | -20.0% |
| Vermont | $209 | $1,175 | 37 | 588 | -20.3% |
| North Dakota | $196 | $999 | 68 | 647 | -25.1% |
| West Virginia | $186 | $706 | 116 | 1,025 | -29.1% |
⚠️ 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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