Colonoscopy Cost

• For those not covered by health insurance, the cost of colonoscopy varies by provider and geographic region, usually ranging from $2,010 to $3,764, with an average of $3,081, according to Blue Cross Blue Shield of North Carolina.
• A colonoscopy often is covered by health insurance if the patient has symptoms that warrant it or if the patient meets age and risk criteria. According to the 2007 Colorectal Cancer Legislation Report Card, 21 states have laws mandating colonoscopy coverage.
• For patients covered by health insurance, out-of-pocket costs can range from zero to more than $1,000, depending on deductibles, copay and coinsurance amounts. For example, a Medicare patient at Dartmouth-Hitchcock Medical Center would pay $1,477, including deductibles and coinsurance. However, some insurance plans, such as the Blue Cross Blue Shield of Michigan Community Blue PPO plan, cover "wellness" screenings 100 percent, with no deductible or copay, usually with some restrictions.

• During the procedure, the patient is sedated, then the doctor uses a flexible tube with a camera and light on it -- a colonoscope -- to examine the rectum and inside the full length of the colon.
• If anything suspicious is found, the doctor can take a sample for biopsy.
• The American Gastroenterological Association has an overview of the procedure.
• The American Academy of Family Physicians has a primer on colorectal cancer screening.

• If polyps need to be removed during the procedure, the cost increases.
• A new procedure called "virtual colonoscopy," an X-ray test that checks for colon cancer, is available. However, it is more expensive and does not detect very small polyps as reliably as a conventional colonoscopy. It is not yet considered an equal alternative to the colonoscopy.

• Some government programs, hospitals and organizations provide free or low-cost screening colonoscopy for uninsured or underinsured individuals. For example, these programs provide services in New York City.
• Flexible sigmoidoscopy, which does not require sedation and can be performed in a doctor's office in 20 minutes or less, costs about $100 to $300, with an average of $200, according to The Kentucky Cancer Consortium and the Action Plan on Colorectal Cancer for the State of Texas. However, it can cost significantly more -- up to about $1,500 if performed in a hospital, which would charge a facility fee. The disadvantage of flexible sigmoidoscopy is that the doctor only is able to view half of the colon, and it is recommended every five years instead of every 10. Studies have shown that the colonoscopy can detect cancers and pre-cancerous lesions that sigmoidoscopy cannot; however, cost and invasiveness make colonoscopy impractical for some.

• If you have a regular doctor, ask for a referral to a gastroenterologist. Otherwise, a gastroenterologist should be board certified in internal medicine by the American Board of Internal Medicine and should have at least an additional two to three years of training on the GI tract.
• Risk factors for colon cancer include being over 50, a family history of the disease and a personal history of inflammatory bowel disease, according to the American Cancer Society.
• The most common side effect of a colonoscopy is cramping and discomfort. Rarely, complications such as perforation of the bowel, requiring surgical repair, can occur.

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