Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
CA SCREEN;FLEXI SIGMOIDSCOPE
Suffern, NY
See all hospitals reporting HCPCS G0104 →Price type
Good Samaritan Hospital’s median price of $3.6k is 258% above the median hospital's median price ($1.0k), higher than 97% of the 1,769 hospitals reporting HCPCS G0104. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 13 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Medicare medicare facility · fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 2 | Molina affinity by molina mcr facility · fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 3 | UnitedHealthcare uhc exchange facility · case rate · outpatient | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 4 | Aetna aetna hp network facility · case rate · outpatient | $3.9k | $3.9k | — | — | — | $3.9k – $3.9k |
| 5 | Blue Cross Blue Shield blue cross connection/exchange facility · case rate · outpatient | $4.0k | $4.0k | — | — | — | $4.0k – $4.0k |
| 6 | UnitedHealthcare uhc commercial facility · case rate · outpatient | $4.1k | $4.1k | — | — | — | $4.1k – $4.1k |
| 7 | UnitedHealthcare uhc empire facility · case rate · outpatient | $4.1k | $4.1k | — | — | — | $4.1k – $4.1k |
| 8 | Aetna aetna facility · case rate · outpatient | $4.4k | $4.4k | — | — | — | $4.4k – $4.4k |
| 9 | Aetna aetna employee facility · case rate · outpatient | $4.4k | $4.4k | — | — | — | $4.4k – $4.4k |
| 10 | Blue Cross Blue Shield blue cross small group facility · case rate · outpatient | $4.8k | $4.8k | — | — | — | $4.8k – $4.8k |
| 11 | Blue Cross Blue Shield blue cross hmo facility · case rate · outpatient | $4.9k | $4.9k | — | — | — | $4.9k – $4.9k |
| 12 | Cigna cigna ppo facility · case rate · outpatient | $5.9k | $5.9k | — | — | — | $5.9k – $5.9k |
| 13 | Tricare tricare facility · fee schedule · outpatient | $6.2k | $6.2k | — | — | — | $6.2k – $6.2k |
Last updated: Jun 29, 2026
See Flexible sigmoidoscopy for colorectal cancer screening pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.