| Procedure | Description | Facility |
| 43235 | Facility Fee/EGD | $693.03 |
| 43236 | Facility Fee/EGO | $993.03 |
| 43239 | Facility Fee/EGO | $912.81 |
| 43243 | Facility Fee/EGO | $930.75 |
| 43245 | Facility Fee/EGO | $945.88 |
| 43247 | Facility Fee/EGO | $935.88 |
| 43248 | Facility Fee/EGO | $945.88 |
| 43249 | Facility Fee/EGO | $945.88 |
| 43250 | Facility Fee/EGO | $936.90 |
| 43251 | Facility Fee/EGO | $936.90 |
| 43255 | Facility Fee/EGO | $933.31 |
| 43450 | Facility Fee/Esophageal Dilation, Unguided Bougie | $620.25 |
| 43760 | Facility Fee/Change of Peg/Gastrostomy Tube | $912.81 |
| 44360 | Facility Fee/Sm Intestine Endoscopy – Push Enteroscopy | $912.81 |
| 44361 | Facility Fee/Sm Intestine Endoscopy – Push w/Bx | $750.00 |
| 44380 | Facility Fee/lleoscopy Thru Stoma | $599.75 |
| 44382 | Facility Fee / lleoscopy Thru Stoma w/Bx | $699.75 |
| 44388 | Facility Fee/Colon Thru Stoma | $910.25 |
| 44389 | Facility Fee/Colon Thru Stoma w/Bx | $925.63 |
| 44392 | Facility Fee/Colon Thru Stoma w/Polyp Removal, Hot Bx | $951.25 |
| 44394 | Facility Fee/Colon Thru Stoma w/Polyp Rem, Not Hot Bx | $943.56 |
| 44799 | Unlisted procedure small intestine | $300.00 |
| 45330 | Facility Fee/Flexible Sigmoidoscopy | $558.75 |
| 45331 | Facility Fee/Flexible Sigmoidoscopy w/Bx | $599.75 |
| 45333 | Facility Fee/Flex Sig w/Polyp Removal | $624.35 |
| 45335 | Facility Fee/Flex Sig w/Submucosal Injection | $300.00 |
| 45338 | Facility Fee/Flex Sig w/Polyp Removal, Snare | $624.35 |
| 45378 | Facility Fee/Colonoscopy | $910.25 |
| 45379 | Facility Fee/Colon w/Removal Foreign Body | $945.63 |
| 45380 | Facility Fee/Colon w/Bx | $925.63 |
| 45381 | Facility Fee/Colon w/Submucosal Injection | $300.00 |
| 45382 | Facility Fee/Colon w/Control of Bleeding | $930.75 |
| 45384 | Facility Fee/Colon w/Polyp Removal, Hot Bx | $951.25 |
| 45385 | Facility Fee/Colon w/Polyp Removal, Snare | $943.56 |
| 45386 | Colsc flexible w/transendoscopic balloon dilat | $1,530.50 |
| 45388 | Facility Fee/Colon w/Ablation | $942.03 |
| 45390 | Facility Fee/Colon w/EMR | $943.56 |
| 46930 | DESTRUCTION OF HEMORRHOIDS | $599.75 |
| 49082 | Facility Fee/Paracentesis w/o Imaging Guidance | $250.00 |
| G0104 | Facility Fee/Flex Sigmoidoscopy Screening | $0.00 |
| G0105 | Facility Fee/Colon Screening, High Risk | $910.25 |
| G0121 | Facility Fee/Colon Screening, Not High Risk | $910.25 |
| G8907 | No Burn/Fall/Site/Transfer | $0.00 |
| G8908 | Pt Burn Documented | $0.00 |
| G8909 | No Pt Burn | $0.00 |
| G8910 | Pt Fall | $0.00 |
| G8911 | No Pt Fall | $0.00 |
| G8912 | Wrong Site/Side/Patient/Procedure | $0.00 |
| G8913 | Not Wrong Site/Side/Patient/Procedure | $0.00 |
| G8914 | Pt Hospital Transfer /Admission | $0.00 |
| G8915 | No Pt Hospital Transfer/Admission | $0.00 |
| G8916 | Antibiotic Prophalaxis Started-on time | $0.00 |
| G8917 | Antibiotic Prophalaxis Started-not on time | $0.00 |
| G8918 | No Order for Antibiotic Prophylaxis | $0.00 |
| MISS APPT | MISSED APPOINTMENT | $100.00 |
*The prices listed are the facility charges that are billed to the insurance. Every insurance company we participate with, we have a contracted allowed amount. To find out what you may be responsible for please contact your insurance company.