HCPCS G0105 at Summit Pacific Medical Center

Colorectal cancer screening; colonoscopy on individual at high risk

Summit Pacific Medical Center, Elma

Description from CMS's HCPCS Level II code file.

What Summit Pacific Medical Center publishes for this code: as an outpatient

Summit Pacific Medical Center’s prices for HCPCS G0105, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	—	$360
Medicare AdvantageInsurer rates	—	$165 – $175
Medicaid managed careInsurer rates	—	$200 – $220
Other government programInsurer rates	—	$165
UnknownInsurer rates	—	$200 – $545
Cash pricePaying yourself, without insurance	—	$735
List priceBefore any discount; few people pay it	—	$1,362

Lowest and highest amounts Summit Pacific Medical Center lists for this code as an outpatient, including lines it lists for both settings or without saying which. Its price file is dated 2026-08-31. This is one line of a bill; most care brings several.

Bills to expect

The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in the rest of Washington for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.

Bills to expect for HCPCS G0105 at Summit Pacific Medical Center
Bill	What it’s for	Original Medicare allows	Private plan estimate
Hospital's feeThe hospital	The service	—	The price above

Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.

Compare HCPCS G0105 at every Washington hospital, with Medicare’s reference amounts.