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Package

Colonoscopy

Package

Colonoscopy

A colonoscopy is a standard medical procedure used to diagnose and treat gastrointestinal tract conditions, particularly those affecting the large intestine (rectum, colon, and anus) and a portion of the small intestine (the ileum). It is the most effective and widely accepted screening tool for identifying colorectal cancer, the third most common cancer and the third leading cause of cancer-related deaths in the United States. Individuals over the age of 50 are advised to undergo colorectal cancer screening at least every ten years.


During a colonoscopy, the physician uses a small, flexible tube with a high-definition camera on the tip, called a colonoscope. The colonoscope also features channels for passing special instruments or fluids and LED lights to illuminate the colon. It is inserted into the patient's anus and slowly advanced through the rectum and colon. The colonoscope allows the physician to visualize the entire colon in real time and identify abnormalities such as polyps, inflammation, infections, or cancer. If abnormalities are detected, the physician can perform a biopsy or remove abnormal tissue during the procedure.


Before the procedure, patients undergo bowel preparation, which includes taking medications to increase bowel movements and following a low-residue or clear liquid diet for one to two days. Bowel preparation ensures that stool and other digestive material do not obstruct the physician’s view of the colon and helps prevent complications such as bowel perforation. Your doctor will provide specific instructions for the preferred bowel preparation method.


Patients are typically under mild sedation during the procedure, administered by an anesthesiologist. Sedation ensures comfort and minimizes movement, reducing the risk of complications. Colonoscopies are generally well-tolerated, with minimal risks that may include rectal tears, bleeding, pain, bloating, or infection.


After the procedure, any biopsies or collected tissue are sent to a laboratory for further examination. Once results are available, they will be reviewed with the patient. Based on the findings, the physician may recommend additional treatment, follow-up colonoscopies, or other interventions for re-evaluation, surveillance, or treatment.

NYC Health and Hospitals - Metropolitan

1901 First Avenue, New York, NY 10029
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Nearest station
96 St
5 minute walk
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Up to
$1,057 / Case Rate

A single, all-inclusive pricing methodology for a procedure in health care contracts, instead of separate charges for each service.

The estimated total cost of care without any insurance coverage or discounts.

NYC Health and Hospitals - Metropolitan
$1,057

Without insurance

What goes into a price?

Prices across providers

This provider
$1,057
Lowest
$580
Highest
$9,798

Self pay or cash prices vary by provider when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts providers charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.

Procedures included in this package

This list includes the services and fees bundled into the Colonoscopy Standard Service Package (SSP GA002). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.

Code Code Type Description
HCPCS 45385 Base Code Colonoscopy
HCPCS 45385 Professional Fee Colonoscopy
RC 0636 Facility Fee Pharmacy - Extension of 025X - Drugs requiring detailed coding
HCPCS J2704 Facility Fee Intramuscular injection of 10mg propofol
RC 0370 Facility Fee Anesthesia - General
HCPCS 88305 Facility Fee Microscopic/gross-exam of surgical pathology biopsies/exam/resections
RC 0750 Facility Fee Gastrointestinal Services - General
RC 0710 Facility Fee Recovery Room - General
RC 0250 Facility Fee Pharmacy (Also see 063X, an extension of 250X) - General

Disclaimer

The NYC Health Department is committed to empowering New York City residents and employees to make informed health care decisions. This tool offers personalized estimates for common health services, providing a clearer picture of potential costs before your visit.

Your final out-of-pocket cost may vary based on your insurance coverage, any discounts, and the specific care you receive. Contact the provider directly to verify your estimate.

Up to
$1,057 / Case Rate

A single, all-inclusive pricing methodology for a procedure in health care contracts, instead of separate charges for each service.

The estimated total cost of care without any insurance coverage or discounts.

NYC Health and Hospitals - Metropolitan

Disclaimer

The NYC Health Department is committed to empowering New York City residents and employees to make informed health care decisions. This tool offers personalized estimates for common health services, providing a clearer picture of potential costs before your visit.

Your final out-of-pocket cost may vary based on your insurance coverage, any discounts, and the specific care you receive. Contact the provider directly to verify your estimate.

What’s the difference between an individual procedure and a Standard Service Package (SSP)?

Individual Procedure

Individual procedures, like blood tests, each have unique prices and billing codes (like a CPT or HCPCS code). While they can be billed alone, they're usually grouped with other procedures on a claim. This grouping is what determines the total cost of your care.

Standard Service Package (SSP)

Turquoise Health has developed SSPs which combine multiple medical services, materials, and fees associated with a health care visit or procedure into a single bundle to offer a more comprehensive estimate. SSPs are designed based on how health care procedures are commonly billed on claims. When discussing estimates with healthcare providers, you can refer to the individual codes listed in the 'Procedures included in this package' section of the tool.

Contact provider to verify your estimate

Have your service name, codes, and payment preference ready. If you’re using insurance, you may be asked for insurance details like your Member or Group ID.

Service Colonoscopy
Service Codes HCPCS 45385, Revenue Code 0636, HCPCS J2704, Revenue Code 0370, HCPCS 88305
Insurance I'm not using insurance
Provider NYC Health and Hospitals - Metropolitan
When you contact them, you can say:
"Hi, I'm calling to verify a price for Colonoscopy I found through NYC Health Department's price estimate tool. Here are the codes I’m looking at: HCPCS 45385, Revenue Code 0636, HCPCS J2704, Revenue Code 0370, HCPCS 88305. I'm not using insurance, can you confirm the cash pay estimate and help me schedule if needed?"