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Procedure price report · Sigmoidoscopy, proctoscopy, and anoscopy

Rigid rectal scope exam to untwist a twisted bowel

CPT 45321the billing code this page is about

A rigid scope is passed into the rectum and lower colon to relieve a twisted, obstructed segment of bowel and release trapped gas and stool.

Hospitals typically charge $656 cash for this outpatient procedure — the median across 320 hospitals that filed a usable cash price; the average of the middle 60% is $1,469. Most fall between $191 and $4,599 (20th–80th percentile).

Hospitals
320
States
43
Filings dated
Jun 2024 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 24, 2026

Median: half of hospitals filed less, half more — and it is a price some hospital actually filed. Average of the middle 60%: the mean of the prices between the 20th and 80th percentiles. We never publish the plain average, the lowest or the highest price: the extremes in hospital price files are chargemaster artefacts, not prices anyone pays.

What hospitals charge, from cheapest to most expensive

Cash price percentiles, outpatient, across 320 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$138$228$656$3,470$5,950

The most expensive tenth of hospitals charges at least 43× what the cheapest tenth charges ($138 vs $5,950).

How the prices are spread

$105 – $163: 24 hospitals$105$163 – $252: 61 hospitals$252 – $389: 46 hospitals$252$389 – $601: 13 hospitals$601 – $928: 4 hospitals$601$928 – $1,433: 6 hospitals$1,433 – $2,215: 22 hospitals$1,433$2,215 – $3,421: 45 hospitals$3,421 – $5,285: 44 hospitals$3,421$5,285 – $8,165: 40 hospitals$5,285median $656price bands are equal on a log scale
Hospitals per price band (305 of 320 — the bands cover the 5th to 95th percentile)
FromToHospitals
$105$16324
$163$25261
$252$38946
$389$60113
$601$9284
$928$1,4336
$1,433$2,21522
$2,215$3,42145
$3,421$5,28544
$5,285$8,16540

Against Medicare

Medicare pays (OPPS 2026, national rate)$2,836
Median cash price$656
Cash as a multiple of Medicare0.23×

The Medicare figure is the national unadjusted OPPS rate for this code — what Medicare itself pays a hospital before local wage adjustment. It is a benchmark, not a price anyone is charged.

By state

The median cash price in each state, against the national median of $656.

Alaska: 2 hospitals filed a usable price — fewer than 10, so no figureAKMaine: 2 hospitals filed a usable price — fewer than 10, so no figureMEVermont: 3 hospitals filed a usable price — fewer than 10, so no figureVTNew Hampshire: 3 hospitals filed a usable price — fewer than 10, so no figureNHWashington: median $245 across 10 hospitalsWA$245Idaho: 6 hospitals filed a usable price — fewer than 10, so no figureIDMontana: 2 hospitals filed a usable price — fewer than 10, so no figureMTNorth Dakota: no hospital in the corpus filed a usable priceNDMinnesota: no hospital in the corpus filed a usable priceMNIllinois: median $228 across 16 hospitalsIL$228Wisconsin: 4 hospitals filed a usable price — fewer than 10, so no figureWIMichigan: median $345 across 25 hospitalsMI$345New York: median $3,245 across 20 hospitalsNY$3,245Massachusetts: 6 hospitals filed a usable price — fewer than 10, so no figureMAOregon: 7 hospitals filed a usable price — fewer than 10, so no figureORNevada: 2 hospitals filed a usable price — fewer than 10, so no figureNVWyoming: 2 hospitals filed a usable price — fewer than 10, so no figureWYSouth Dakota: no hospital in the corpus filed a usable priceSDIowa: median $253 across 17 hospitalsIA$253Indiana: 5 hospitals filed a usable price — fewer than 10, so no figureINOhio: 8 hospitals filed a usable price — fewer than 10, so no figureOHPennsylvania: median $31 across 14 hospitalsPA$31New Jersey: median $3,986 across 24 hospitalsNJ$3,986Connecticut: 2 hospitals filed a usable price — fewer than 10, so no figureCTRhode Island: no hospital in the corpus filed a usable priceRICalifornia: median $5,096 across 41 hospitalsCA$5,096Utah: no hospital in the corpus filed a usable priceUTColorado: 2 hospitals filed a usable price — fewer than 10, so no figureCONebraska: 8 hospitals filed a usable price — fewer than 10, so no figureNEMissouri: 6 hospitals filed a usable price — fewer than 10, so no figureMOKentucky: 4 hospitals filed a usable price — fewer than 10, so no figureKYWest Virginia: 3 hospitals filed a usable price — fewer than 10, so no figureWVVirginia: 7 hospitals filed a usable price — fewer than 10, so no figureVAMaryland: 1 hospital filed a usable price — fewer than 10, so no figureMDDelaware: no hospital in the corpus filed a usable priceDEArizona: 2 hospitals filed a usable price — fewer than 10, so no figureAZNew Mexico: 1 hospital filed a usable price — fewer than 10, so no figureNMKansas: 5 hospitals filed a usable price — fewer than 10, so no figureKSArkansas: 2 hospitals filed a usable price — fewer than 10, so no figureARTennessee: 7 hospitals filed a usable price — fewer than 10, so no figureTNNorth Carolina: 1 hospital filed a usable price — fewer than 10, so no figureNCSouth Carolina: 3 hospitals filed a usable price — fewer than 10, so no figureSCOklahoma: median $170 across 13 hospitalsOK$170Louisiana: 7 hospitals filed a usable price — fewer than 10, so no figureLAMississippi: 3 hospitals filed a usable price — fewer than 10, so no figureMSAlabama: 3 hospitals filed a usable price — fewer than 10, so no figureALGeorgia: no hospital in the corpus filed a usable priceGAHawaii: 1 hospital filed a usable price — fewer than 10, so no figureHITexas: median $1,843 across 16 hospitalsTX$1,843Florida: 4 hospitals filed a usable price — fewer than 10, so no figureFL
Cash price by state, most expensive first. National median $656. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
California CA41$5,096+677%$3,653 – $8,165
New Jersey NJ24$3,986+508%$3,035 – $5,855
New York NY20$3,245+395%$315 – $3,245
Texas TX16$1,843+181%$1,843 – $1,843
Michigan MI25$345−47%$323 – $566
Iowa IA17$253−61%$253 – $253
Washington WA10$245−63%$155 – $2,556
Illinois IL16$228−65%$200 – $4,987
Oklahoma OK13$170−74%$170 – $3,451
Pennsylvania PA14$31−95%$25 – $4,004
Nebraska NE8not enough hospitals filed a usable price
Ohio OH8not enough hospitals filed a usable price
Louisiana LA7not enough hospitals filed a usable price
Oregon OR7not enough hospitals filed a usable price
Tennessee TN7not enough hospitals filed a usable price
Virginia VA7not enough hospitals filed a usable price
Idaho ID6not enough hospitals filed a usable price
Massachusetts MA6not enough hospitals filed a usable price
Missouri MO6not enough hospitals filed a usable price
Indiana IN5not enough hospitals filed a usable price
Kansas KS5not enough hospitals filed a usable price
Florida FL4not enough hospitals filed a usable price
Kentucky KY4not enough hospitals filed a usable price
Wisconsin WI4not enough hospitals filed a usable price
Alabama AL3not enough hospitals filed a usable price
Mississippi MS3not enough hospitals filed a usable price
New Hampshire NH3not enough hospitals filed a usable price
South Carolina SC3not enough hospitals filed a usable price
Vermont VT3not enough hospitals filed a usable price
West Virginia WV3not enough hospitals filed a usable price
Alaska AK2not enough hospitals filed a usable price
Arkansas AR2not enough hospitals filed a usable price
Arizona AZ2not enough hospitals filed a usable price
Colorado CO2not enough hospitals filed a usable price
Connecticut CT2not enough hospitals filed a usable price
Maine ME2not enough hospitals filed a usable price
Montana MT2not enough hospitals filed a usable price
Nevada NV2not enough hospitals filed a usable price
Wyoming WY2not enough hospitals filed a usable price
Hawaii HI1not enough hospitals filed a usable price
Maryland MD1not enough hospitals filed a usable price
North Carolina NC1not enough hospitals filed a usable price
New Mexico NM1not enough hospitals filed a usable price

Hospitals like yours

The same distribution cut by the kind of hospital. Hospital type and ownership come from CMS; a hospital counts as part of a system when its price file is shared with at least one other hospital under the same brand. The national median is $656.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care266$1,843$195 – $4,881
Children’s4fewer than 20 hospitals
Critical access50$240$166 – $1,049
Ownership
For-profit24$364$228 – $5,041
Government50$291$170 – $3,245
Non-profit246$1,479$193 – $5,096
System affiliation
Part of a system257$1,687$191 – $5,041
Independent63$328$195 – $2,875

Cash price vs list price

Median list price (chargemaster)$538
Median cash price$656
Cash as a share of list, median hospital60%

At the typical hospital, asking for the cash price cuts the list price by about 40%. The share is the median of each hospital’s own cash ÷ list ratio, over hospitals that filed both — not the ratio of the two medians above.

The same procedure, inpatient

207 hospitals filed a usable inpatient cash price for this code. The median is $359 and the average of the middle 60% is $1,555; most fall between $175 and $5,096.

Cash price percentiles, inpatient, across 207 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$124$193$359$4,777$8,165

The most expensive tenth of hospitals charges at least 66× what the cheapest tenth charges ($124 vs $8,165).

Of the 232 hospitals that filed this code inpatient, 207 gave a usable cash price; 13 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 12 a list price only.

How complete is this

320 of the 3,956 hospitals with a price file in our corpus (8%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 363 hospitals that filed this code at all gave us
Usable cash price — counted320
Cash price carrying a plausibility flag — shown on the compare tool, excluded here32
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded1
An estimate rather than a filed cash price — excluded0
A list price only, no cash figure — excluded10
Hospitals that filed this code363

Sections not shown for this setting

  • Since our last snapshot: there is no earlier snapshot at least 90 days older than this one yet.

We last checked these hospitals’ price files for changes between September 4, 2026 and September 24, 2026; the figures were computed September 25, 2026 from filings loaded through September 24, 2026. The percentiles and averages use only the “counted” row.

Related procedures

Part of the Sigmoidoscopy, proctoscopy, and anoscopy family.

Hospitals file this code under descriptions such as PR Proctosigmoidoscopy,Decompr Volvul.

Method

Source
The machine-readable price files every U.S. hospital is required by CMS to publish, parsed per hospital. Nothing is surveyed, sampled or modelled.
What counts
One cash (self-pay) price per hospital for this code and setting. A hospital’s own filing can rule its number out — a placeholder, a “not applicable” note, a list price standing in for cash — and our plausibility checks can flag a price far below what every other hospital files. Both kinds are disclosed above and excluded from the statistics; on the compare tool a flagged price is still shown.
Statistics
Percentiles are discrete: each is a price some hospital filed. The average is the mean of the prices between the 20th and 80th percentiles. We never publish the plain mean, the minimum or the maximum. A state needs 10 hospitals and a segment 20 to show a figure; otherwise the row shows its count and no number. Medicare is the national unadjusted OPPS rate where one exists.
Names
Procedure names on these pages are our own plain-language titles, not the AMA’s copyrighted CPT descriptors. The code is the identity.

The full rules — sources, statistics, thresholds, limitations — are on the methodology page.

Download this page’s figures: JSON · CSV. Aggregates only — the per-hospital prices are on the compare tool.

Cite: HospitalRates.com, “Rigid rectal scope exam to untwist a twisted bowel (CPT 45321) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-45321-rigid-rectal-scope-exam-to-untwist-a-twisted-bowel