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Colonoscopy with polyp removal: what insurers pay

A colonoscopy where polyps are removed with a snare (45385) or hot biopsy forceps (45384). Commercial negotiated rates by hospital and market, next to Medicare for the same code.

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CPT 45385: Colonoscopy With Polyp Removal

1508 hospitals in 82 markets. National Medicare rate $1,223, surgery center $657.

MarketHospitals25th pctMedian75th pctLow–high
Alabama (statewide)21$1,286$1,882$2,207$675–$6,532
Alaska (statewide)6$1,134$2,034$5,193$919–$7,564
Arizona (statewide)12$1,983$2,537$3,080$772–$5,282
Arkansas (statewide)16$1,110$1,296$1,592$568–$1,730
Atlanta GA10$3,812$3,870$4,140$3,601–$4,140
Austin TX13$966$2,376$3,385$966–$3,385
Boston MA16$1,522$1,766$1,958$980–$2,490
California (statewide)70$1,762$3,479$4,462$804–$8,005
Charlotte NC6$1,402$1,402$1,402$1,383–$5,050
Chicago IL11$2,558$2,860$3,434$1,520–$4,566
Cleveland OH11$2,432$2,932$3,152$2,068–$3,528
Colorado (statewide)19$2,259$2,862$4,262$1,033–$6,520
Columbus OH1———$4,304–$4,304
Connecticut (statewide)4———$951–$4,986
Dallas-Fort Worth TX12$2,789$2,877$3,016$2,462–$4,598
Delaware (statewide)1———$3,252–$3,252
Denver CO15$1,922$4,098$4,312$1,336–$5,026
Detroit MI17$1,056$1,200$1,411$662–$5,085
Florida (statewide)70$2,512$2,984$3,442$673–$9,199
Georgia (statewide)45$2,500$3,437$3,792$1,094–$4,797
Hawaii (statewide)7$3,488$3,534$4,598$1,898–$5,672
Houston TX19$2,284$2,613$2,810$1,734–$3,695
Idaho (statewide)19$1,206$1,402$2,150$801–$3,575
Illinois (statewide)36$1,694$2,246$3,081$665–$4,898
Indiana (statewide)46$1,780$2,798$4,470$704–$8,220
Indianapolis IN3———$726–$4,978
Iowa (statewide)37$1,134$1,414$2,173$579–$3,631
Kansas (statewide)49$1,350$1,621$2,274$585–$7,564
Kentucky (statewide)22$1,421$1,892$2,436$1,011–$5,965
Las Vegas NV2———$2,017–$2,590
Los Angeles CA14$3,455$3,497$3,993$2,832–$5,842
Louisiana (statewide)24$1,197$1,434$1,866$1,004–$3,728
Maine (statewide)17$4,652$4,831$5,425$1,183–$7,052
Maryland (statewide)1———$3,063–$3,063
Massachusetts (statewide)10$1,221$1,766$2,269$1,120–$2,553
Miami-Fort Lauderdale FL2———$1,899–$2,744
Michigan (statewide)36$990$1,136$1,192$657–$1,820
Minneapolis-St. Paul MN10$2,155$2,352$2,549$1,712–$2,697
Minnesota (statewide)29$2,037$2,383$3,574$1,092–$4,858
Mississippi (statewide)25$1,350$1,848$2,044$804–$3,982
Missouri (statewide)36$1,526$2,300$2,987$601–$6,278
Montana (statewide)8$2,164$2,591$3,451$708–$4,764
Nashville TN8$1,970$2,404$2,426$1,492–$2,474
Nebraska (statewide)27$1,236$2,550$3,262$663–$6,799
Nevada (statewide)7$2,017$2,017$2,392$1,014–$3,118
New Hampshire (statewide)7$2,440$3,548$4,426$733–$5,359
New Jersey (statewide)24$2,039$3,586$6,204$1,288–$8,615
New Mexico (statewide)10$2,011$2,222$3,440$1,020–$4,947
New York (statewide)40$1,674$2,604$3,348$842–$6,759
New York City8$1,766$1,778$3,689$1,766–$7,034
North Carolina (statewide)11$1,814$2,601$2,964$1,190–$4,154
North Dakota (statewide)9$2,040$2,382$2,383$1,055–$5,550
Ohio (statewide)47$2,312$2,851$4,046$608–$4,671
Oklahoma (statewide)22$864$1,906$2,596$580–$6,536
Oregon (statewide)16$2,639$3,096$3,981$1,344–$5,460
Pennsylvania (statewide)50$1,950$2,672$3,477$1,071–$5,881
Philadelphia PA11$3,039$3,598$3,660$2,605–$8,155
Phoenix AZ8$2,658$2,678$2,706$2,600–$2,788
Pittsburgh PA12$1,750$2,049$2,594$1,512–$2,968
Portland OR9$4,922$5,144$5,144$4,922–$5,158
Rhode Island (statewide)6$1,615$2,052$3,103$1,159–$4,052
Richmond VA3———$4,146–$4,816
Rio Grande Valley TX6$1,570$1,971$2,826$1,555–$3,154
Salt Lake City UT9$1,453$1,453$1,453$1,453–$1,453
San Antonio TX3———$1,882–$2,800
San Diego CA7$2,616$2,616$2,633$2,201–$2,838
San Francisco Bay Area CA6$3,635$4,682$5,570$3,546–$9,589
Seattle-Tacoma WA16$3,432$3,558$4,128$2,873–$4,870
South Carolina (statewide)28$2,048$3,076$4,935$749–$8,667
South Dakota (statewide)7$1,924$2,383$3,446$905–$6,074
St. Louis MO10$1,711$1,920$1,920$1,576–$2,740
Tampa FL6$1,300$1,300$1,989$1,300–$6,648
Tennessee (statewide)28$1,446$1,821$2,002$1,144–$2,500
Texas (statewide)87$1,704$2,613$2,923$672–$8,220
Utah (statewide)16$1,453$1,453$1,453$652–$4,126
Vermont (statewide)5$721$3,044$3,666$666–$4,260
Virginia (statewide)24$3,971$4,564$5,051$2,116–$6,169
Washington (statewide)16$2,267$3,035$3,520$1,013–$6,476
Washington DC9$2,857$2,857$3,273$2,857–$3,488
West Virginia (statewide)12$1,938$2,087$3,894$1,309–$7,967
Wisconsin (statewide)48$2,503$3,077$4,013$632–$6,834
Wyoming (statewide)2———$688–$688

Lowest and highest 12 hospital medians

HospitalMarketMedian across insurers× MedicareInsurersFile date
Mercy Hospital OzarkArkansas (statewide)$5680.5×12026-06-08
Guthrie County HospitalIowa (statewide)$5790.5×12026-09-26
Ascension St John Medical CenterOklahoma (statewide)$5800.5×12026-01-01
Amberwell HiawathaKansas (statewide)$5850.5×62026-08-18
Okeene Municipal HospitalOklahoma (statewide)$5850.5×32026-08-12
Nemaha Valley Community HospitalKansas (statewide)$5860.5×32026-09-16
Amberwell Atchison AssociationKansas (statewide)$5900.5×22026-08-18
Cass County Memorial HospitalIowa (statewide)$5980.5×32026-06-01
Pemiscot County Memorial HospitalMissouri (statewide)$6010.5×12026-07-01
Iowa Specialty Hospital - BelmondIowa (statewide)$6070.5×22026-04-22
Iowa Specialty Hospital - ClarionIowa (statewide)$6070.5×22026-06-11
Selby General HospitalOhio (statewide)$6080.5×12026-10-01
Providence St Joseph HospitalCalifornia (statewide)$7,5684.9×42026-04-01
Logan Regional Medical CenterWest Virginia (statewide)$7,9676.9×12026-04-01
Providence Redwood Memorial HospitalCalifornia (statewide)$8,0055.2×32026-04-01
Inspira Medical Center VinelandNew Jersey (statewide)$8,1556.1×12026-03-24
Inspira Medical Center Mullica HillPhiladelphia PA$8,1556.1×12026-03-24
Parkview Regional Medical CenterIndiana (statewide)$8,2206.5×12026-09-01
Parkview HospitalTexas (statewide)$8,2206.8×12026-09-01
Jfk University Medical CenterNew Jersey (statewide)$8,6156.4×52025-12-31
Mcleod Loris HospitalSouth Carolina (statewide)$8,6677.8×12026-07-20
Mcleod Health ClarendonSouth Carolina (statewide)$8,6677.8×12026-07-20
Holy Cross HospitalFlorida (statewide)$9,1997.4×242026-03-31
Stanford Health CareSan Francisco Bay Area CA$9,5895.5×12026-04-01

Every hospital is on its state's page (linked in the market table) and in the interactive explorer.

CPT 45384: Colonoscopy With Polyp Removal

1331 hospitals in 80 markets. National Medicare rate $1,223, surgery center $657.

MarketHospitals25th pctMedian75th pctLow–high
Alabama (statewide)19$1,308$1,882$2,276$728–$6,532
Alaska (statewide)6$1,063$2,082$5,216$825–$7,337
Arizona (statewide)10$1,404$2,316$2,741$772–$5,282
Arkansas (statewide)10$1,076$1,124$1,577$568–$1,730
Atlanta GA10$3,812$3,870$4,140$3,601–$4,140
Austin TX12$966$1,671$3,385$966–$3,385
Boston MA12$1,696$1,846$2,031$1,120–$2,348
California (statewide)67$2,130$3,479$4,462$980–$8,005
Charlotte NC6$1,402$1,402$1,402$1,383–$5,050
Chicago IL11$2,300$2,819$3,434$1,284–$4,142
Cleveland OH11$2,432$2,932$3,152$1,857–$3,528
Colorado (statewide)19$1,695$2,792$4,206$1,012–$6,520
Columbus OH1———$4,304–$4,304
Connecticut (statewide)3———$1,566–$11,565
Dallas-Fort Worth TX12$2,789$2,877$3,016$2,462–$4,598
Denver CO15$1,556$4,001$4,312$1,336–$5,026
Detroit MI14$1,200$1,200$1,573$666–$2,417
Florida (statewide)71$2,396$2,970$3,442$649–$9,199
Georgia (statewide)40$2,678$3,514$3,792$1,094–$4,797
Hawaii (statewide)5$1,537$1,898$3,493$1,468–$5,672
Houston TX19$2,284$2,613$2,810$1,734–$3,695
Idaho (statewide)16$1,279$2,036$2,995$798–$3,575
Illinois (statewide)34$1,661$2,200$2,973$905–$4,898
Indiana (statewide)42$1,662$2,698$4,445$649–$8,220
Indianapolis IN3———$649–$4,978
Iowa (statewide)30$1,258$1,884$2,416$615–$3,631
Kansas (statewide)37$1,242$1,729$2,077$602–$7,337
Kentucky (statewide)20$1,522$1,892$2,386$1,056–$4,082
Las Vegas NV2———$2,017–$2,590
Los Angeles CA16$3,438$3,497$3,906$2,795–$5,842
Louisiana (statewide)20$1,219$1,347$1,866$1,004–$3,728
Maine (statewide)16$4,831$5,483$5,609$1,183–$7,052
Maryland (statewide)1———$2,572–$2,572
Massachusetts (statewide)6$1,741$1,878$2,400$1,523–$2,553
Miami-Fort Lauderdale FL2———$1,899–$2,744
Michigan (statewide)29$1,016$1,140$1,192$657–$1,820
Minneapolis-St. Paul MN9$2,138$2,515$2,560$1,260–$2,697
Minnesota (statewide)26$2,357$2,383$3,192$961–$4,697
Mississippi (statewide)23$1,306$1,644$2,029$804–$3,264
Missouri (statewide)25$1,628$2,385$3,081$909–$4,587
Montana (statewide)7$1,934$2,476$3,478$754–$4,764
Nashville TN8$2,033$2,404$2,426$1,637–$2,474
Nebraska (statewide)21$1,714$2,431$3,262$693–$6,799
Nevada (statewide)6$2,017$2,017$2,286$1,014–$2,408
New Hampshire (statewide)7$2,440$3,548$4,426$650–$5,359
New Jersey (statewide)23$1,816$3,390$6,211$1,368–$8,615
New Mexico (statewide)9$1,979$2,358$3,552$1,020–$4,947
New York (statewide)37$1,874$2,538$3,171$842–$6,083
New York City8$2,538$2,538$3,480$2,232–$7,034
North Carolina (statewide)8$2,036$2,856$3,240$1,404–$4,154
North Dakota (statewide)8$2,073$2,382$2,461$1,132–$5,550
Ohio (statewide)43$2,410$2,830$4,046$1,008–$4,600
Oklahoma (statewide)15$1,223$1,664$2,546$584–$6,536
Oregon (statewide)13$2,494$3,020$3,877$1,115–$5,460
Pennsylvania (statewide)38$1,951$2,546$3,406$1,158–$5,538
Philadelphia PA11$3,039$3,598$3,660$2,605–$8,155
Phoenix AZ8$2,658$2,678$2,706$2,600–$2,788
Pittsburgh PA11$1,744$2,092$2,597$1,512–$2,968
Portland OR9$5,144$5,158$5,762$5,144–$5,762
Rhode Island (statewide)5$1,606$2,462$3,317$1,159–$4,052
Richmond VA3———$4,146–$4,816
Rio Grande Valley TX5$1,615$2,158$2,993$1,555–$3,154
Salt Lake City UT9$1,453$1,453$1,453$1,453–$1,453
San Antonio TX3———$1,882–$2,800
San Diego CA7$2,616$2,616$2,633$2,201–$2,838
San Francisco Bay Area CA5$4,899$5,460$5,606$3,903–$9,589
Seattle-Tacoma WA16$3,432$3,558$4,128$2,873–$4,870
South Carolina (statewide)28$2,394$3,150$4,935$749–$8,667
South Dakota (statewide)5$1,467$2,383$2,831$1,274–$6,074
St. Louis MO7$1,920$1,920$1,922$1,711–$2,740
Tampa FL6$1,300$1,300$1,989$1,300–$6,648
Tennessee (statewide)26$1,426$1,659$2,026$1,084–$2,500
Texas (statewide)77$1,503$2,613$2,923$724–$8,220
Utah (statewide)16$1,453$1,453$1,453$635–$4,126
Vermont (statewide)4———$650–$4,165
Virginia (statewide)24$3,971$4,564$5,051$2,116–$6,169
Washington (statewide)13$2,916$3,122$3,580$678–$6,476
Washington DC4———$2,978–$3,488
West Virginia (statewide)6$2,003$2,952$4,553$1,309–$7,967
Wisconsin (statewide)42$2,855$3,077$4,626$802–$6,834

Lowest and highest 12 hospital medians

HospitalMarketMedian across insurers× MedicareInsurersFile date
Mercy Hospital OzarkArkansas (statewide)$5680.5×12026-06-08
Ascension St John Jane PhillipsOklahoma (statewide)$5840.5×12026-01-01
Ascension St John NowataOklahoma (statewide)$5840.5×12026-01-01
Ascension St John OwassoOklahoma (statewide)$5910.5×12026-01-01
Amberwell HiawathaKansas (statewide)$6020.6×42026-08-18
Amberwell Atchison AssociationKansas (statewide)$6120.6×22026-08-18
Boone County HospitalIowa (statewide)$6150.5×12026-07-27
San Juan HospitalUtah (statewide)$6350.5×22026-04-13
Ascension St Vincent'S Clay CountyFlorida (statewide)$6490.5×12026-01-01
Ascension St Vincent KokomoIndiana (statewide)$6490.5×12026-01-01
Ascension St Vincent AndersonIndianapolis IN$6490.5×12026-01-01
Ascension St Vincent RandolphIndiana (statewide)$6490.5×12026-01-01
Logan Regional Medical CenterWest Virginia (statewide)$7,9676.9×12026-04-01
Providence Redwood Memorial HospitalCalifornia (statewide)$8,0055.2×32026-04-01
Inspira Medical Center VinelandNew Jersey (statewide)$8,1556.1×12026-03-24
Inspira Medical Center Mullica HillPhiladelphia PA$8,1556.1×12026-03-24
Parkview Regional Medical CenterIndiana (statewide)$8,2206.5×12026-09-01
Parkview HospitalTexas (statewide)$8,2206.8×12026-09-01
Jfk University Medical CenterNew Jersey (statewide)$8,6156.4×52025-12-31
Mcleod Loris HospitalSouth Carolina (statewide)$8,6677.8×12026-07-20
Mcleod Health ClarendonSouth Carolina (statewide)$8,6677.8×12026-07-20
Holy Cross HospitalFlorida (statewide)$9,1997.4×242026-03-31
Stanford Health CareSan Francisco Bay Area CA$9,5895.5×12026-04-01
Saint Francis Hospital & Medical CenterConnecticut (statewide)$11,5658.0×192026-03-31

Every hospital is on its state's page (linked in the market table) and in the interactive explorer.

Questions

How much do commercial insurers pay hospitals for colonoscopy with polyp removal?

Across 1508 hospitals in 82 markets (metro areas and statewide) that post a usable dollar rate, the median commercial rate for CPT 45385, hospital outpatient is $2,503, 2.0× the same hospital's local Medicare base rate. The middle half of hospitals runs $1,531 to $3,479. Figures are each hospital's median across insurers, from its federal price-transparency file.

What does Medicare pay for colonoscopy with polyp removal?

Medicare's national hospital outpatient rate for CPT 45385 is $1,223 and its surgery-center rate is $657, before local wage adjustment.

Which hospitals post the lowest and highest commercial rates for colonoscopy with polyp removal?

Lowest medians: Mercy Hospital Ozark ($568), Guthrie County Hospital ($579), Ascension St John Medical Center ($580). Highest: Stanford Health Care ($9,589), Holy Cross Hospital ($9,199), Mcleod Health Clarendon ($8,667). Coverage: every hospital whose price file we could read.