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Biopsy Of The Anal And Rectal Wall

North Carolina 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?

$562

Typical facility fee. In North Carolina, July 2026.

Insurers have agreed to pay about $562 for this service. Most negotiated rates run $355 to $3,467.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $562 · 10th to 90th $295 to $5,248Professionalmedian $417 · 10th to 90th $417 to $417
$500$1K$2K$5K$10Kfacility $562professional $417

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$3,019.95
Typical High
$6,456.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,513.56
Median
$1,778.28
Typical High
$1,995.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$1,348.96
Typical High
$2,691.53
Medcost
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$416.87
Medcost
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$363.08
Typical High
$575.44
United
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$2,041.74
Typical High
$6,309.57
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$8,128.31
Median
$8,128.31
Typical High
$19,498.45

Where North Carolina sits

The same service costs 25.1 times more in Delaware 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.

North Carolina· 41st of 50

$562

DE $8,913MD $355

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.