The average endoscopy cost in the United States falls between $1,500 and $10,000 without insurance, depending on the type of procedure, where it is performed, and whether biopsies or polyp removal are involved. Upper endoscopies (EGDs) and colonoscopies are among the most commonly ordered diagnostic procedures in the country — the American Society for Gastrointestinal Endoscopy estimates over 20 million are performed annually. Understanding what drives these prices can save you hundreds or even thousands of dollars on a single procedure. Our healthcare costs guide covers more procedures and pricing benchmarks across the healthcare system.
Average Endoscopy Cost by Procedure Type
The word “endoscopy” covers several distinct procedures, each with its own pricing range. Your gastroenterologist will recommend a specific approach based on your symptoms, medical history, and what part of the gastrointestinal tract needs examination. These estimates reflect national averages from Healthcare Bluebook and CMS data.
Upper Endoscopy (EGD)
An esophagogastroduodenoscopy — EGD for short — typically costs $1,500 to $4,500 without insurance. The gastroenterologist passes a thin, flexible scope through your mouth to examine the esophagus, stomach, and upper portion of the small intestine. The procedure takes 15 to 30 minutes and is performed under sedation. If biopsies are taken during the procedure — which happens in roughly 30% to 50% of EGDs — expect an additional $200 to $600 in pathology fees that will appear on a separate bill from the pathology lab. Common reasons for ordering an EGD include persistent heartburn, difficulty swallowing, unexplained abdominal pain, suspected ulcers, and celiac disease screening.
Colonoscopy
Diagnostic colonoscopies range from $2,000 to $5,500 without insurance. The procedure examines the entire large intestine and typically takes 30 to 60 minutes. Screening colonoscopies for patients over 45 with average risk are fully covered under the ACA’s preventive care provisions — meaning no copay, coinsurance, or deductible for in-network providers. This zero-cost coverage represents significant savings given the base price of the procedure. However, if polyps are found and removed, some insurers have historically reclassified the procedure as diagnostic, which can trigger cost-sharing. Recent federal legislation and CMS guidance have pushed insurers to cover polyp removal during screening colonoscopies without additional charges, but some grandfathered plans may not comply. Always verify with your insurer beforehand.
Capsule Endoscopy
Capsule endoscopy, where you swallow a pill-sized camera that photographs your digestive tract as it passes through, costs $1,000 to $3,500 without insurance. It is typically used to examine the small intestine — a region that standard scopes cannot reach — and is commonly ordered for unexplained gastrointestinal bleeding, suspected Crohn’s disease, or small bowel tumors. The capsule itself accounts for $500 to $800 of the total cost, and the images are reviewed by a gastroenterologist over several hours, which contributes to the physician interpretation fee. The entire process takes eight hours for the capsule to transit your system, though you can go about your normal activities during that time.
Endoscopic Ultrasound (EUS)
An endoscopic ultrasound combines endoscopy with ultrasonography and costs $2,500 to $6,000 without insurance. It is a specialized procedure used to evaluate pancreatic masses, bile duct stones, submucosal GI tumors, and certain cancers. EUS requires additional training and equipment, which accounts for the higher price point compared to standard EGD.
What Makes Up the Endoscopy Bill
Three separate charges typically appear on your statement, often from different billing entities. The facility fee — whether a hospital outpatient department or ambulatory surgery center — represents the largest portion, often $1,000 to $4,000. This covers the procedure room, nursing staff, monitoring equipment, and supplies. Next comes the physician’s professional fee for performing and interpreting the procedure, ranging from $300 to $1,000. Anesthesia or sedation adds another $300 to $800, with monitored anesthesia care (MAC) using propofol costing more than moderate conscious sedation administered by the endoscopist with midazolam and fentanyl.
Pathology charges for biopsies are billed separately and can add $150 to $600 depending on the number of specimens and the complexity of analysis. Pre-procedure labs and the consultation visit that led to the endoscopy order are also separate line items that contribute to the total episode cost. If you need help finding a specialist, our guide on how to find a gastroenterologist can point you in the right direction.
Endoscopy Cost With Insurance vs Without Insurance
With private insurance, your out-of-pocket cost for a diagnostic upper endoscopy typically ranges from $200 to $1,500, depending on your plan’s deductible and coinsurance structure. If you have not yet met your deductible, you may owe the full negotiated rate up to that threshold. After meeting the deductible, most plans cover 70% to 90% of the remaining cost, leaving you with coinsurance of $100 to $500. Plans with separate specialist copays may charge $40 to $75 for the physician’s fee component.
Medicare pays approximately $300 to $600 for the physician component and sets separate facility payment rates based on whether the procedure is performed in a hospital outpatient department or ambulatory surgery center. Beneficiaries on Original Medicare with Part B pay 20% coinsurance after meeting the annual deductible — roughly $80 to $200 for a straightforward EGD. Medicare Advantage plans may have different cost-sharing structures, so check your specific plan summary.
Without insurance, expect to pay the full billed amount unless you negotiate. Many endoscopy centers offer cash-pay packages ranging from $1,200 to $2,500 that bundle the facility, physician, and anesthesia fees into one transparent price. These packages can be significantly cheaper than hospital-based pricing and eliminate the confusion of receiving three or four separate bills. GoodRx and similar platforms list cash-pay endoscopy prices in many metro areas, giving you a starting point for comparison shopping.
Hospital vs Ambulatory Surgery Center: A Major Price Gap
Where you have the procedure matters almost as much as what procedure you have. Hospital outpatient departments charge facility fees that are 50% to 100% higher than freestanding ambulatory surgery centers (ASCs), according to CMS payment data. A colonoscopy at a hospital might generate a facility charge of $3,000 to $4,000, while the same procedure at an ASC across the street runs $1,200 to $1,800.
ASCs are safe, accredited facilities that handle millions of endoscopies annually. They are inspected by state health departments and accredited by organizations like AAAHC or the Joint Commission. Unless you have a complex medical history that requires hospital-level monitoring — such as severe cardiopulmonary disease, morbid obesity requiring specialized anesthesia support, or anticoagulation management — choosing an ASC is one of the simplest ways to cut your endoscopy cost dramatically. Ask your gastroenterologist whether they perform procedures at both hospital and ASC settings, and compare the price at each.
How to Save Money on an Endoscopy
Ask about screening vs diagnostic classification. If your colonoscopy is ordered as a screening for a patient at average risk and performed in-network, ACA rules require zero cost-sharing. Make sure your doctor codes it correctly — the difference between a screening code (CPT 45378) and a diagnostic code can mean thousands of dollars. If you have symptoms or a family history, the procedure may still qualify as a screening depending on your plan and the specific coding.
Choose an ambulatory surgery center. As noted above, ASCs are substantially cheaper than hospital outpatient departments. Ask your gastroenterologist which facilities they work at and request a cost estimate from each. Many patients are surprised to learn their doctor operates at both a hospital and an ASC, and that they have a choice.
Request a cash-pay bundle. Uninsured patients or those with high-deductible plans often save money by paying the bundled cash price upfront rather than running the charges through insurance. Some centers advertise all-inclusive colonoscopy packages for $1,500 to $2,000 — a price that may be lower than what you would owe after applying charges to an unmet $3,000 deductible.
Shop around with price transparency tools. Tools like Healthcare Bluebook, your insurer’s online cost estimator, and hospital price transparency files (required by federal law since 2021) can reveal wide price variations within your area. Endoscopy pricing can differ by 300% between facilities in the same city.
Confirm every provider is in-network. Your gastroenterologist may be in-network, but the anesthesiologist assigned on the day of the procedure may not be. Similarly, the pathology lab receiving your biopsy specimens may be out-of-network. The No Surprises Act offers protections at in-network facilities, but verifying in advance prevents billing disputes and anxiety.
Ask about sedation options. Moderate (conscious) sedation with midazolam and fentanyl, administered by the endoscopist, is less expensive than monitored anesthesia care (MAC) with propofol, which requires an anesthesiologist or CRNA. For routine upper endoscopies and colonoscopies in healthy patients, moderate sedation is clinically adequate and can save $200 to $500 on the anesthesia component.
Frequently Asked Questions
Is a screening colonoscopy really free?
Under the ACA, screening colonoscopies are covered with no cost-sharing for patients at average risk when performed by an in-network provider. This applies to most private insurance plans, marketplace plans, and Medicare. However, if your plan is grandfathered (in effect before March 2010 and not substantially changed), it may not be required to cover preventive screenings at zero cost. If polyps are found and removed during the screening, recent federal guidance directs insurers to cover polyp removal without additional cost-sharing, though compliance varies. Always verify with your specific plan before scheduling.
How much does an endoscopy cost with Medicare?
With Original Medicare Part B, you typically pay 20% coinsurance after meeting the annual deductible (approximately $240 in 2024). For an upper endoscopy, that works out to roughly $80 to $250 out of pocket depending on the setting. Screening colonoscopies for eligible beneficiaries have no cost-sharing under Medicare. If you have a Medicare Supplement (Medigap) policy, it may cover some or all of the remaining coinsurance.
Why is my endoscopy bill so much higher at a hospital?
Hospitals charge a facility fee that reflects their higher overhead — emergency departments, 24/7 staffing, complex infrastructure, and regulatory compliance costs. These expenses are distributed across all outpatient procedures, including endoscopies. Ambulatory surgery centers have lower operating costs, smaller staffing requirements, and more streamlined operations, allowing them to charge significantly less. The clinical quality and safety of the endoscopy itself is equivalent in accredited ASC settings for the vast majority of patients.
Can I negotiate my endoscopy bill?
Yes. Uninsured patients and those facing high out-of-pocket costs can often negotiate 20% to 50% off billed charges. Contact the billing department before the procedure to discuss self-pay rates, cash-pay bundles, or interest-free payment plans. Many facilities prefer a guaranteed upfront payment at a discount over billing the full amount and chasing collections for months. If you have already received a bill, negotiation is still possible — ask for an itemized bill, review it for errors, and offer a reasonable lump-sum settlement.
The Bottom Line
Endoscopy costs vary dramatically based on procedure type, facility choice, and insurance status. An upper endoscopy or colonoscopy can range from a few hundred dollars with good insurance to $5,000 or more without coverage at a hospital outpatient department. The single most impactful move you can make is choosing an ambulatory surgery center over a hospital — this alone can cut your bill by 40% to 60%. Pair that with cash-pay bundles, correct procedure coding, sedation choice, and network verification, and you can keep your endoscopy cost well within a manageable range. Do not let pricing uncertainty delay a procedure your doctor has recommended — the information exists to help you plan.