Cash Fee Schedule

May 2019*

CPT


43235

43239

43248

Upper Endoscopy: EGD (Esophagogastroduodenoscopy)


EGD without biopsy

EGD with biopsy

Dilation of esophageal location (guide wire)

Cash Price


$ 935.00

$ 1,035.00

$ 1,045.00

CPT


G0121

G0105

45378

45385

Lower Endoscopy: Colonoscopy


Screening colonoscopy low risk without biopsy

Screening colonoscopy high risk (history of polyps)

Diagnostic colonoscopy without biopsy (symptoms)

Diagnostic colonoscopy with snare polypectomy (with or without symptoms)

Cash Price


$ 1,020.00

$ 1,080.00

$ 1,080.00

$ 1,375.00

CPT


99204

99214

Office Visits


New patient

Established patient

Cash Price


$ 295.00

$ 195.00

* This fee schedule is an estimate of expected cost for the services listed. Patient will be financially responsible if additional or different services are performed. We reserve the right to change these fees without notice. Patient must pay by cash, check or credit card in advance of the procedure date or at time of service. Applies only to procedures performed in our Endoscopy Center. Cash fees do not apply if the patient is covered by an insurance company contracted with Spokane Digestive.