Biopsy Of The Anal And Rectal Wall

Nationwide rates for HCPCS 45100

Takes a sample of the full thickness of the wall of the rectum just above the anus, working through the anal opening rather than through the abdomen. It is most often done in a baby or young child to look for the missing nerve cells that cause a form of severe constipation present from birth. The laboratory examination of the sample is charged separately.

Rates data updated July 2026.

How much does Biopsy Of The Anal And Rectal Wall cost?

$3,447

Typical total for the visit. Nationwide, July 2026.

Insurers have agreed to pay about $3,447 for this procedure. That total is two separate charges: $427 to the doctor who performs it, and $3,020 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

12% physician fee88% facility fee

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 60 insurance carriers under federal price transparency rules.

What's inside this number

Part of the bill	Who charges it	Typical	Range
Physician feeThe doctor who performs it	The doctor who performs it	$427	$324 to $676
Facility feeThe hospital or surgery center	The hospital or surgery center	$3,020	$1,000 to $5,370

How much rates vary

Facilitymedian $3,020 · 10th to 90th $380 to $8,710Professionalmedian $427 · 10th to 90th $288 to $1,122

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Facility Modifier Global Typical Low $524.81 Median $3,162.28 Typical High $9,120.11	Facility	Global	$524.81	$3,162.28	$9,120.11
BCBS Setting Facility Modifier Global Typical Low $1,513.56 Median $4,168.69 Typical High $10,000.00	Facility	Global	$1,513.56	$4,168.69	$10,000.00
Cigna Setting Facility Modifier Global Typical Low $371.54 Median $891.25 Typical High $2,454.71	Facility	Global	$371.54	$891.25	$2,454.71
United Setting Facility Modifier Global Typical Low $645.65 Median $2,570.40 Typical High $6,456.54	Facility	Global	$645.65	$2,570.40	$6,456.54

What it costs in each state

The same service costs 6.4 times more in Wisconsin than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

Touch or drag across the chart to see any state's rate.

WI $4,974MD $781

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.