A LEEP, or loop electrosurgical excision procedure, removes abnormal cervical tissue with a thin wire loop carrying an electric current. It takes about 10 minutes of actual cutting and is usually recommended after a colposcopy biopsy comes back showing a high-grade lesion.
The price does not follow the procedure. It follows the room. The exact same LEEP can be a $500 office visit with a numbing injection or an $8,000 day at a hospital with an anesthesiologist, and which one you get is often decided by scheduling habit rather than anything about your case. This guide prices both, plus the bills that arrive afterward, using published cash rates and 2024 CMS claims data as of September 2026.
What Does a LEEP Cost Without Insurance?
Prepaid marketplace ranges and clinic self-pay rates below are current as of September 2026. Billed-charge figures come from the CMS Medicare Physician & Other Practitioners file and the CMS Medicare Outpatient Hospitals file, both 2024 claims released in 2026.
| Service / Type | Low | Average | High |
|---|---|---|---|
| LEEP in office, prepaid cash (MDsave) | $444 | $642 | $1,453 |
| LEEP in office, flat clinic self-pay rate | $500 | n/a | $680 |
| LEEP at a hospital or surgery center, prepaid cash (MDsave) | $3,889 | $5,888 | $8,017 |
| Pathology, CPT 88305, per specimen, published self-pay lab rate | $93 | n/a | $160 |
| Pathology, CPT 88307, cone specimen, published self-pay lab rate | $364 | n/a | $627 |
| CPT 57460 LEEP biopsy, office (average billed charge) | n/a | $1,102.14 | n/a |
| CPT 57461 LEEP conization, office (average billed charge) | n/a | $1,231.90 | n/a |
| CPT 57522 cold knife conization, facility (average billed charge) | n/a | $1,948.61 | n/a |
| CPT 00940 anesthesia, vaginal procedure, facility (average billed charge) | n/a | $1,083.24 | n/a |
| CPT 57460 hospital outpatient claim (average total charges billed) | n/a | $15,150.31 | n/a |
Sources: MDsave’s national prepaid listings for LEEP procedure in office and LEEP procedure at a facility; Atlanta Midtown Gynecology publishes a flat $500 LEEP rate excluding pathology and Planned Parenthood of Florida publishes $500 to $680; self-pay pathology rates are Delta Pathology’s $92.53 for CPT 88305 and $363.87 for 88307 and Pathology Laboratory Associates’ $160.00 and $627.28 for the same codes; physician billed charges are national averages in the CMS 2024 physician file; the hospital outpatient figure is the average total charges billed on 2024 outpatient claims containing CPT 57460, against which Medicare allowed an average of $3,011.53.
Note the size of that last gap. Hospitals bill an average of roughly $15,150 in total charges on a LEEP claim and Medicare pays about a fifth of it. Nobody actually pays $15,150, but that is the number an uninsured patient gets billed if she never asks for anything else.
What Drives the Price
Office versus operating room
This is the whole story. An office LEEP uses a paracervical block, a local anesthetic injection, and you drive yourself home. A hospital or ambulatory surgery center LEEP adds an anesthesia provider, a recovery bay and a facility fee.
MDsave’s national prepaid averages tell you what that costs: $642 in an office, $5,888 at a facility. The clinical indication for one over the other is real in some cases (a very large lesion, a very anxious patient, a cervix that is hard to reach) but plenty of LEEPs get scheduled into an OR simply because that is where the practice does them.
The facility fee that only exists in one setting
A hospital outpatient department bills a facility charge that an office cannot bill. In 2024 CMS outpatient data, the average Medicare-allowed amount on a hospital outpatient LEEP claim was $3,011.53 for CPT 57460 and $2,991.36 for 57461, both mapped to APC 5414 (Level 4 Gynecologic Procedures). That allowed amount is the hospital’s share alone. The gynecologist’s professional fee is billed on a separate claim on top of it.
Anesthesia is a third bill
If you are sedated, an anesthesiologist or CRNA bills you directly. In 2024 CMS data, CPT 00940 (anesthesia for a vaginal procedure) carried an average submitted charge of $1,083.24 in facility settings, with Medicare allowing $100.51. Anesthesia bills are one of the most common sources of surprise balances after a procedure people thought was fully quoted.
Pathology is a fourth bill
The excised tissue goes to a pathologist. A straightforward LEEP specimen is usually billed as CPT 88305 and a formal cone specimen as 88307. On published self-pay lab schedules that is $92.53 to $160.00 for 88305 and $363.87 to $627.28 for 88307.
Atlanta Midtown Gynecology’s price list says outright that its $500 LEEP does not include the pathology charge. Assume yours does not either, and ask which lab your practice uses.
LEEP versus cold knife cone
A cold knife conization (CPT 57522) uses a scalpel instead of a loop, removes a larger cone-shaped piece of cervix, and is done in an OR under general anesthesia. In 2024 CMS data it carried an average submitted charge of $1,948.61 in facility settings against $1,320.96 for a LEEP biopsy, and on the hospital outpatient side average total charges were $17,110.86 versus $15,150.31.
So the professional fee difference is modest. The setting difference is not, because a cold knife cone essentially never happens in an office.
Cash Price vs. Insurance
A LEEP is treatment, not screening, so no preventive-coverage rule makes it free. With insurance you are paying a deductible and coinsurance on a procedure priced somewhere between $913 and $11,427 depending on where it happens, which is exactly why the setting matters as much for insured patients as for uninsured ones.
For a cash-pay patient the arithmetic is simple. An office LEEP at $500 plus $93 to $160 of pathology is $593 to $660 all in. The same procedure at a hospital, quoted from the chargemaster, can be more than ten times that. Prepaying through a marketplace at $3,889 to $8,017 is better than the chargemaster and still far worse than the office.
The one genuine argument for the facility route is that some plans cover an operating-room LEEP and not an in-office one, or your clinician has a clinical reason to do it under general anesthesia. If neither applies, ask directly whether the practice offers the office version.
Because insurance status can change the entire equation here, read the Medicaid section below before you decide to self-pay. A high-grade cervical lesion is one of a small number of diagnoses that opens a special Medicaid pathway regardless of income in many states.
How to Pay Less
- Apply for the Breast and Cervical Cancer Prevention and Treatment Program. This is the single biggest lever on this page. Under the federal Breast and Cervical Cancer Prevention and Treatment Act, states may provide full Medicaid to uninsured people under 65 who are screened and diagnosed with cervical cancer or a precancerous condition of the cervix. Pennsylvania’s version states there are no income or resource limits, and that coverage extends to all your medical needs during treatment, not just the cervix. Your clinic’s staff usually completes part of the application with you, so ask about it at the visit where the biopsy results are given.
- Ask for the in-office LEEP explicitly. The phrasing that works: “do you offer LEEP in the office under local anesthetic, and what is the self-pay price.” Published office rates are $500 to $680. Check any quote against our fair price checker.
- Get the pathology quoted separately. Call the lab your practice uses and ask for its self-pay rate on 88305 or 88307 before the specimen is sent. The spread between labs on the cone code is more than $260 per specimen.
- Use a sliding-scale clinic. Planned Parenthood affiliates and community health centers price LEEP on income, and Planned Parenthood of Florida publishes a flat $500 to $680. Our guide to free clinics and sliding-scale care explains how to find one.
- Pull the hospital’s posted cash price before agreeing to a facility date. Hospitals must publish a discounted cash price for shoppable services, and it is frequently a fraction of the chargemaster number. Our hospital price transparency guide walks through finding and reading the file.
- If the bills already came, split them and fight each one. Request an itemized hospital bill so the facility, anesthesia, surgeon and pathology charges are visible separately, then work each with our negotiation guide and phone script. Large balances should go to hospital charity care before anything else, and if a bill has already been sold, read our guide to medical bills in collections.
Where LEEP Sits in the Cervical Care Chain
The billing pathway is predictable, which makes it possible to budget for the whole thing rather than one procedure at a time. A Pap smear comes back abnormal. That triggers a colposcopy at $232 to $990 in an office plus pathology. If the biopsy shows a high-grade lesion, a LEEP follows at $444 to $1,453 in an office. Then a follow-up visit and repeat testing at 6 and 12 months, each of which is another office visit and another cytology charge.
Priced end to end in the office setting, that chain runs roughly $1,200 to $2,800 with pathology. Priced end to end through a hospital, it can pass $10,000. Nothing clinical distinguishes those two paths.
Other gynecologic procedures with the same setting-driven spread include a D&C and endometrial ablation. If a hysterectomy ever comes up in the same conversation, price it separately, because it is a different scale entirely.
This is a cost guide and not medical guidance. Whether a LEEP is the right treatment, and which setting is appropriate for your case, is a conversation for a clinician. What it should cost, and which program might pay for it, is what this page is for.
Bottom Line
A LEEP is a $500 to $680 office procedure at practices that publish flat cash rates and a $3,889 to $8,017 procedure once a facility, an anesthesia provider and a hospital billing department are involved. Pathology adds $93 to $627 on a bill that arrives later, from a company you did not choose.
Before paying any of it, ask your clinic to check you for Breast and Cervical Cancer Prevention and Treatment Program Medicaid. A precancerous cervical diagnosis qualifies, many states apply no income limit, and it is the difference between a four-figure bill and no bill at all.