A Cost Benefit Analysis of sedated vs. unsedated colonoscopy based on the VA perspective and a 24- hour time horizon is presented. Study data came from the NCHCS Sacramento VA, GI Clinic on demand sedation study, a RCT comparing air vs. water techniques. Data were also used from the VA Allocation Resource Center (ARC) Web, VA DSS Costing Data; workload data, as well as reports from the Veterans Support Service Center (VSSC) Web. VA’s direct costs are primarily personnel and medications. Since both procedures use the same space, that direct cost is ignored when examining the difference between the procedures. Fixed costs are costs that do not vary with level of output. The VA perspective obtains a difference of approximately $58 per procedure, favoring the unsedated alternative, regardless of whether the air or the water technique was used.