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Procedure price report · Sigmoidoscopy, proctoscopy, and anoscopy

Flexible sigmoidoscopy with biopsy

CPT 45331the billing code this page is about

A flexible scope examines the rectum and lower colon and one or more tissue samples are taken for laboratory testing, whether one or several biopsies are done.

Hospitals typically charge $1,000 cash for this outpatient procedure — the median across 1,697 hospitals that filed a usable cash price; the average of the middle 60% is $1,125. Most fall between $376 and $2,503 (20th–80th percentile).

Hospitals
1,697
States
50
Filings dated
Aug 2022 – 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 1,697 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
$236$465$1,000$2,132$3,352

The most expensive tenth of hospitals charges at least 14× what the cheapest tenth charges ($236 vs $3,352).

How the prices are spread

$152 – $214: 69 hospitals$152$214 – $301: 91 hospitals$301 – $423: 145 hospitals$301$423 – $595: 164 hospitals$595 – $837: 184 hospitals$595$837 – $1,178: 224 hospitals$1,178 – $1,657: 192 hospitals$1,178$1,657 – $2,332: 180 hospitals$2,332 – $3,281: 175 hospitals$2,332$3,281 – $4,616: 105 hospitals$3,281median $1,000price bands are equal on a log scale
Hospitals per price band (1,529 of 1,697 — the bands cover the 5th to 95th percentile)
FromToHospitals
$152$21469
$214$30191
$301$423145
$423$595164
$595$837184
$837$1,178224
$1,178$1,657192
$1,657$2,332180
$2,332$3,281175
$3,281$4,616105

Against Medicare

Medicare pays (OPPS 2026, national rate)$950
Median cash price$1,000
Cash as a multiple of Medicare1.05×

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 $1,000.

Alaska: median $1,125 across 11 hospitalsAK$1,125Maine: median $404 across 12 hospitalsME$404Vermont: median $406 across 11 hospitalsVT$406New Hampshire: median $640 across 17 hospitalsNH$640Washington: median $625 across 42 hospitalsWA$625Idaho: median $1,786 across 16 hospitalsID$1,786Montana: median $470 across 20 hospitalsMT$470North Dakota: median $938 across 17 hospitalsND$938Minnesota: median $843 across 72 hospitalsMN$843Illinois: median $788 across 59 hospitalsIL$788Wisconsin: median $898 across 51 hospitalsWI$898Michigan: median $873 across 65 hospitalsMI$873New York: median $847 across 64 hospitalsNY$847Massachusetts: median $1,422 across 39 hospitalsMA$1,422Oregon: median $511 across 33 hospitalsOR$511Nevada: median $420 across 10 hospitalsNV$420Wyoming: 8 hospitals filed a usable price — fewer than 10, so no figureWYSouth Dakota: median $835 across 10 hospitalsSD$835Iowa: median $662 across 57 hospitalsIA$662Indiana: median $528 across 44 hospitalsIN$528Ohio: median $2,408 across 83 hospitalsOH$2,408Pennsylvania: median $1,558 across 69 hospitalsPA$1,558New Jersey: median $1,217 across 40 hospitalsNJ$1,217Connecticut: median $2,264 across 15 hospitalsCT$2,264Rhode Island: 8 hospitals filed a usable price — fewer than 10, so no figureRICalifornia: median $2,132 across 94 hospitalsCA$2,132Utah: 3 hospitals filed a usable price — fewer than 10, so no figureUTColorado: median $813 across 30 hospitalsCO$813Nebraska: median $702 across 40 hospitalsNE$702Missouri: median $926 across 53 hospitalsMO$926Kentucky: median $596 across 26 hospitalsKY$596West Virginia: median $430 across 25 hospitalsWV$430Virginia: median $1,131 across 35 hospitalsVA$1,131Maryland: 3 hospitals filed a usable price — fewer than 10, so no figureMDDelaware: 4 hospitals filed a usable price — fewer than 10, so no figureDEArizona: median $2,626 across 15 hospitalsAZ$2,626New Mexico: median $1,745 across 21 hospitalsNM$1,745Kansas: median $489 across 48 hospitalsKS$489Arkansas: median $501 across 20 hospitalsAR$501Tennessee: median $673 across 27 hospitalsTN$673North Carolina: median $1,352 across 38 hospitalsNC$1,352South Carolina: median $2,292 across 29 hospitalsSC$2,292Oklahoma: median $764 across 30 hospitalsOK$764Louisiana: median $578 across 33 hospitalsLA$578Mississippi: median $727 across 30 hospitalsMS$727Alabama: median $1,306 across 26 hospitalsAL$1,306Georgia: median $1,204 across 41 hospitalsGA$1,204Hawaii: 9 hospitals filed a usable price — fewer than 10, so no figureHITexas: median $618 across 97 hospitalsTX$618Florida: median $1,820 across 47 hospitalsFL$1,820
Cash price by state, most expensive first. National median $1,000. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Arizona AZ15$2,626+163%$928 – $4,375
Ohio OH83$2,408+141%$875 – $3,353
South Carolina SC29$2,292+129%$1,625 – $2,292
Connecticut CT15$2,264+126%$884 – $3,225
California CA94$2,132+113%$692 – $3,030
Florida FL47$1,820+82%$653 – $3,344
Idaho ID16$1,786+79%$825 – $2,509
New Mexico NM21$1,745+75%$739 – $4,137
Pennsylvania PA69$1,558+56%$914 – $3,157
Massachusetts MA39$1,422+42%$630 – $2,536
North Carolina NC38$1,352+35%$979 – $1,896
Alabama AL26$1,306+31%$739 – $3,440
New Jersey NJ40$1,217+22%$1,010 – $4,627
Georgia GA41$1,204+20%$575 – $1,801
Virginia VA35$1,131+13%$907 – $2,655
Alaska AK11$1,125+13%$362 – $1,365
North Dakota ND17$938−6%$374 – $1,919
Missouri MO53$926−7%$369 – $2,746
Wisconsin WI51$898−10%$462 – $1,206
Michigan MI65$873−13%$282 – $2,412
New York NY64$847−15%$262 – $2,368
Minnesota MN72$843−16%$365 – $1,654
South Dakota SD10$835−16%$676 – $897
Colorado CO30$813−19%$339 – $1,628
Illinois IL59$788−21%$396 – $2,099
Oklahoma OK30$764−24%$339 – $1,859
Mississippi MS30$727−27%$235 – $1,945
Nebraska NE40$702−30%$424 – $1,950
Tennessee TN27$673−33%$306 – $1,641
Iowa IA57$662−34%$333 – $1,671
New Hampshire NH17$640−36%$126 – $1,286
Washington WA42$625−37%$290 – $1,253
Texas TX97$618−38%$547 – $1,757
Kentucky KY26$596−40%$187 – $3,661
Louisiana LA33$578−42%$267 – $1,035
Indiana IN44$528−47%$184 – $2,867
Oregon OR33$511−49%$263 – $1,124
Arkansas AR20$501−50%$206 – $725
Kansas KS48$489−51%$255 – $1,210
Montana MT20$470−53%$137 – $1,949
West Virginia WV25$430−57%$200 – $1,630
Nevada NV10$420−58%$293 – $1,114
Vermont VT11$406−59%$284 – $1,438
Maine ME12$404−60%$293 – $777
Hawaii HI9not enough hospitals filed a usable price
Rhode Island RI8not enough hospitals filed a usable price
Wyoming WY8not enough hospitals filed a usable price
Delaware DE4not enough hospitals filed a usable price
Maryland MD3not enough hospitals filed a usable price
Utah UT3not 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 $1,000.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care1,158$1,204$526 – $2,824
Children’s24$739$290 – $2,755
Critical access510$586$260 – $1,533
Ownership
For-profit183$1,424$547 – $3,547
Government364$739$321 – $1,671
Non-profit1,145$1,010$396 – $2,536
System affiliation
Part of a system1,323$1,079$447 – $2,678
Independent374$681$249 – $1,700

Cash price vs list price

Median list price (chargemaster)$1,786
Median cash price$1,000
Cash as a share of list, median hospital65%

At the typical hospital, asking for the cash price cuts the list price by about 35%. 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

955 hospitals filed a usable inpatient cash price for this code. The median is $938 and the average of the middle 60% is $1,091; most fall between $374 and $2,292.

Cash price percentiles, inpatient, across 955 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
$209$483$938$1,994$3,030

The most expensive tenth of hospitals charges at least 15× what the cheapest tenth charges ($209 vs $3,030).

Of the 1,059 hospitals that filed this code inpatient, 955 gave a usable cash price; 50 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 54 a list price only.

How complete is this

1,697 of the 3,956 hospitals with a price file in our corpus (43%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 1,827 hospitals that filed this code at all gave us
Usable cash price — counted1,697
Cash price carrying a plausibility flag — shown on the compare tool, excluded here68
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded0
An estimate rather than a filed cash price — excluded7
A list price only, no cash figure — excluded55
Hospitals that filed this code1,827

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 Sigmoidoscopy Flx W/Biopsy Single/Multiple.

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, “Flexible sigmoidoscopy with biopsy (CPT 45331) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-45331-flexible-sigmoidoscopy-with-biopsy