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Colonoscopy Cost

How Much Does a Colonoscopy Cost?

low cost With Insurance Coverage: Copay, Coinsurance and Deductibles
low costHigh: Without Insurance Average $3,081

Related Topics:

Mammogram

Pap Test

Virtual Colonoscopy

Biopsy

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A colonoscopy is a screening test for colon cancer. It is recommended that people of average risk get a colonoscopy or other type of screening every 10 years starting at age 50. People at high risk should begin screening earlier, and sometimes more often, according to the American Cancer Society.
 
Typical costs:
  • 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.
What should be included:
  • 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.
Additional costs:
  • 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.
Discounts:
  • 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.
Shopping for a colonoscopy:
  • 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.
Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
 
Article updated March 2008
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What People Are Paying - Recent Comments

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Colonoscopy Cost Ommission by Carrier
Amount: $263.00
Posted by: Carondelet in Allentown, PA.Posted: December 25th, 2010 11:12PM
Clinic or Doctor: Insurance Carrier: BIG Life/Medical Insurance Co
Type of Policy: PPO
At 63 I was overdue for my first colonoscopy. Dr. suggested a screening. I called insurance to find out what this will cost. Covered 100%! If, however, for example I had to be rushed to surgery if something went awry, then ER copay & 5% hospital coinsurance would apply. Otherwise fully covered at 100%! Found/removed one benign polyp. Explanation of Benefits just came & shows a charge of $263 expected from hospital. I asked insurance company why? One said "facility charge". Uh, how do you get a colonoscopy without a facility, at your house? Another said, "a diagnosis" was submitted. Isn't that the point of a screening? Reading these comments, it must have been the lone polyp that triggered a charge. Aren't polyps typical? How many screenings are done with no polyps at all? Could they have said when I asked, up front, what will this really cost? No, all they said is Covered 100%. Pretty sleezey, bait & switch insurance company. I don't fault the hospital.
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Colonoscopy
Amount: $5.00
Posted by: Maggieloe in Sacramento, CA.Posted: December 29th, 2010 10:12PM
Clinic or Doctor: Kaiser of Northern CaliforniaInsurance Carrier: Kaiser of Northern Californa
Type of Policy: Senior advantage
$5.00 was my co-pay for the Colyte solution.
After reading other comments I feel fortunate for myself but absolutely shocked at the state of our patchwork healthcare system.
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Colonoscopy Cost
Amount: $0.00
Posted by: Cary NC Resident in Cary, NC.Posted: December 31st, 2010 12:12PM
Clinic or Doctor: Raleigh NC EndoscopyInsurance Carrier: Cigna
Type of Policy: Open Access Plus
The procedure was done under sedation and at the endoscopy center. This was fully covered under my insurance as long as it was only a screening.
If any polyps were detected or biopsies, then the screening becomes a diagnostic test, and you would incure charges for 25% of negotiated rates betweent the inurance co. and facility. Since nothing was detected, this was 100% paid for.
Re-test in 10 years. Would highly reccomend this
office, group of doctors and facility, no problems from start to finish. 53yr old female.
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Colonoscopy
Amount: $8,894.00
Posted by: patient in iowa in Bettendorf, IA.Posted: January 3rd, 2011 02:01PM
Clinic or Doctor: Gastroenterology centerInsurance Carrier: Aetna
Type of Policy: PPO
Three claims, one for biopsy 394, facilities, 4700, doctor 3800. My portion came to about 1100. Insurance paid their approved amount.

Not bad for less than 2 hours work from all involved.
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Colonoscopy
Amount: $0.00
Posted by: Sandra Byers in Vero Beach, FL.Posted: January 20th, 2011 10:01AM
Clinic or Doctor: Outpatient ClinicInsurance Carrier: Freedom Health
Type of Policy: PPO
I'm on medicare and so far I'm happy with my coverage. The colonoscopy was covered as a preventablbe procedure and cost me 0.00. If you have polyps removed you will receive a pathology report.
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Colonoscopy/Endoscopy
Amount: $4,000.00
Posted by: Disgusted in Portland, OR.Posted: February 22nd, 2011 01:02PM
Clinic or Doctor: Oregon ClinicInsurance Carrier: First Health, Assurant
Type of Policy: Deductable
Called my insurance before the proceedure to verify coverage. As a preventative proceedure, yes at 100%. However once they find something it is no longer considered preventative and becomes a new bill code. My bills are still coming in from the insurance being adjusted for cost. The proceedure at this point is up to $7,000 with my cost being close to $4,000 out of pocket. When you consider how much you pay in premiums and the cost after adjusted it almost makes you want to just take your chances. If I had known it would cost that much I would have opted not to get it done.
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colonoscopy cost
Amount: $0.00
Posted by: mk1966 in anywhere, WI.Posted: March 8th, 2011 12:03PM
I am a physician. Most physicians make half of what the hopsital bill shows as the physician cost. The rest goes to "overhead". If you all read all the comments in this thread, you will see a few trends. The lowest costs go to the uninsured, those under universal care, and those going to the VA and city hospitals. The third party, private insurance creates an overhead-heavy machinery that all of us pay for. Let's go the way of the VA and city hospitals and push for universal health care managed via the government, not private parties.
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Colonoscopy
Amount: $1,500.00
Posted by: Tom236 in portland, OR.Posted: March 8th, 2011 10:03PM
Clinic or Doctor: ProvidenceInsurance Carrier: Healthnet
Type of Policy: deductable
I had a Colonoscopy and a tube stuck down my throat ( I forget what that is called) I got it from both ends!!!
Everything turned out ok....no polyups.
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COLONOSCOPY
Amount: $250.00
Posted by: SS in LOS ANGELES, CA.Posted: March 11th, 2011 11:03PM
Clinic or Doctor: Insurance Carrier: ANTHEM BLUE CROSS
Type of Policy: LUMENOS
Lumenos Plan is is the only one in the state of CA that will cover cost of a preventative colonoscopy 100%. However, what I found out later is the cost of the Propfil (anthesia) used during the procedure is NOT covered. But after reading the entries here, my $250.00 cost for the meds was a deal. And I would recomend this plan to all.
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Colonoscopy Cost
Amount: $20,950.00
Posted by: sheilavan in Irvine, CA.Posted: April 9th, 2011 06:04PM
Clinic or Doctor: ClinicInsurance Carrier: Health Net
Type of Policy: PPo
Yes, that's right, $20,950. The facility fee was $14,250, the doctor fee $2200 and biopsy for polyps $4500. Albeit mine included an endoscopy. Facility was a outpatient surgical center. Not sure how much insurance will pay, under review.
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Colonoscopy
Amount: $0.00
Posted by: RogerB in Erie, PA.Posted: April 18th, 2011 12:04PM
Posted by: Big Chuck in Chicago, IL. Posted: November 16th, 2010 12:11PM
To those of you who state that the total billed was $20,000 and the insurance only paid $1000 this is NOT the reason healtcare costs are so high.

The providers are contracted with the insurance companies. These are the negotiated rates that the providers have agreed to. The providers charge so much for those of us who DO NOT have insurance. The providers are the reason that health care costs are so high, not the insurance companies. Please people, get a clue

Big Chuck
If what you said is true!!!!! Then what we the people of the USA need is to have the government negotiate all medical fees for medical services.
Then create a web site to list these prices. making them available to everyone in the country (USA) Example Colonoscopy $269.00 Total cost all fees included. Once this is created then the insurance companies can create a product to protect the people from the real cost not the fictitious retailprices
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Colonoscopy
Amount: $0.00
Posted by: a user in Minneapolis, MN.Posted: April 25th, 2011 05:04PM
Clinic or Doctor: Minnesota GastroInsurance Carrier: BCBS Minnesota
Type of Policy: PPO
Blue Cross paid $1268 total for the doctor and facility; this is about a %75 discount from MN Gastro's stated bill of $1630.

Because this screening colonoscopy fell under the new health care reform, it cost nothing out of pocket with an individual, high-deductible policy.
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over charge and I am out of luck
Amount: $450.00
Posted by: prowlersfish in Hampton, VA.Posted: June 10th, 2011 03:06PM
Clinic or Doctor: sentaraInsurance Carrier: optima
Type of Policy: ppo
Told it was cover 100% if the doctor use a screening code ,I told the Dr. office this , the said no problem as my insurance is owned by the Hospital . Now I owe at least $450 , hosp. says its the Docs fault . the billing people will not help , Beware of OPTIMA HEALTH .BTW I have to pay 4400 for a hernia repair too ( done 2 weeks later ,
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colonoscopy
Amount: $100.00
Posted by: Rick n Mobile in mobile, AL.Posted: June 20th, 2011 01:06PM
Clinic or Doctor: Dr / Hospital Out PatientInsurance Carrier: BCBSAL
Type of Policy: Group
Total cost was around $2,200 - facility and dr. I don't remember what the costs were on the two previous colonoscopies.

It has been almost 5 years, and I guess I am going to be inquiring about another since I am considered high risk (precancerous polyps found during 1st one and have active diverticculosis)
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Colonoscopy
Amount: $1,100.00
Posted by: a user in Braintree, MA.Posted: June 23rd, 2011 08:06PM
Clinic or Doctor: South Shore EndoscopyInsurance Carrier: Tufts Health Ins
Type of Policy: Group
A routing colonscopy changes to surgery if even one tiny polyp is found and removed the insurance company now charges you for the procedure. What a scam. The polyp was not sent out for biopsy. So if the doctor did not think the polyp was suitable for biopsy why is it removed? Why does the insurance company not assume that the patient pays out of pocket for half the cost of the procedure. Tufts is going to be one less subscriber next year. They really suck! Plus I pay $1700 per month for this crappy policy while all the illegals and free loaders get it carte blanche! Just waint until the system is FREE!
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Colonoscopy
Amount: $1,950.00
Posted by: a user in Austin, TX.Posted: July 12th, 2011 03:07PM
Clinic or Doctor: Austin GastroInsurance Carrier: BCBS TX
Type of Policy: Individual
Quoted $0 as required under new health care law. Removed 3 polyps so they changed code from screening to surgery as a result the $0 quote was thrown out. deductible was $1500 and the 25% Bill $7332, write down $4061, insurance paid $1321, cost me $1950. Consumer beware. The insurance company will always find a way to screw you.
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Colonoscopy
Amount: $5,250.70
Posted by: cost concern patient in Torrance, CA.Posted: August 3rd, 2011 11:08AM
Clinic or Doctor: Prov. Ltl. Co. Mary,Torr.Insurance Carrier: Anthem Blue Cross
Type of Policy: Lumenos
I had a colonoscopy 4 years ago, it was considered preventive wellness, less than $50.00. This time the Hospital bill alone is $5,250.70 my pay is $1,167.86. Not only is the cost over 100% they code it as "Abdominal Surgery".
When I questioned the cost and thought it was due to wrong coding. PLCM Hospital just rattled off their sing song response, saying the medical cost have increased significantly and the coding is correct! Procedure had nothing to do with my stomach!!! Go figure. We do need monetary control in health care. I feel the start of all these exorbitant fees/charges started years ago when "get-rich" lawyers talked millions of people into frivolous(not the ones w/merit) medical lawsuits that in turn caused Medical personel and Providers to charge more to cover lawsuits. Domino effect.
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colonoscopy insurance confusion
Amount: $0.00
Posted by: colog in pittsburgh, PA.Posted: September 1st, 2011 11:09AM
Clinic or Doctor: SW GastroInsurance Carrier: BCBS
Type of Policy: PPO
I had rectal bleeding (age 55) and was referred for colonocopy. I checked with BCBS and they said no charge for the first exam unless a polyp was removed and they couldn't tell me if anesthesia was covered in full or not. I told the doc to do a screening exam only and to not but not remove any polyps that she may find; I put this on the consent and she reluctantly signed it (actually this is no different from a virtual where no polyps can be removed so I told the doc not to get her panties in a bunch; she agreed). Nobody could tell me if anesthesia (propofol, not the garbage conscious sedation with Versed given by a nurse) was covered so I politely asked to skip it especially when I was told that a CRNA (nurse) would do it not an anesthesiologist. The CRNA offered to do the propofol free as a professional courtesy, but I declined for safety reasons.
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Colonoscopy
Amount: $0.00
Posted by: Eliza Hill in Wilmington, DE.Posted: September 3rd, 2011 10:09PM
Clinic or Doctor: Lobos, iraInsurance Carrier: BC/BS. Med/care
Great experience. No pain,comfortable area and compassionate staff.
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Colonoscopy
Amount: $950.00
Posted by: Michael M in Tampa, .Posted: September 19th, 2011 05:09PM
Clinic or Doctor: Surgery CenterInsurance Carrier: None
Type of Policy: Self Pay
Had my colonoscopy 5 years ago and it cost me $400 with my BCBS insurance.
Now I don't have insurance for 2 years and I called my local hospital and they quoted me $4,000 and said it could be more if they had to do pathology.
Ended up using a program called colonoscopy assist to get it done for much cheaper. They wouldn't schedule me at the same hospital so I had to go to a different one instead but was worth saving $3000. Colonoscopies are a rip off for the 30 minutes it takes to do them.
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Be A Smart Consumer!
Amount: $0.00
Posted by: a user in St. Paul, MN.Posted: December 10th, 2011 10:12AM
Make sure you read your policy and ask informed questions about getting a colonoscopy. In most of these cases, your ins company is giving you the CORRECT information about undergoing a colonoscopy. It is preventative, and thus a fairly low out of pocket cost. The problem most folks are encountering is that everything changes once you get a polyp removed. It is not the insurance company's fault that you did not understand your policy. It is not enough to just ask about your coverage! Talk to your doctor! Yes, it can be expensive to get a polyp removed, but it is generally assumed that this is what will happen when you undergo a colonoscopy. Do your research before getting any medical test done. Generally, you want to get any polyp removed, regardless of the cost. This is what the POINT of a colonoscopy is! The problem with the health care system in the US is not just greedy physicians, it's consumers that enter into medical procedures without doing their homework.
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Colonoscopy Charges
Amount: $348.48
Posted by: Colonoscopy Patient in Munster, IN.Posted: January 17th, 2012 04:01AM
Clinic or Doctor: Community Hospital, Munster, INInsurance Carrier: BCBS of IL
Type of Policy: HDHP - PPO
Hospital charges totalled $2660, with the negotiated insurance rate knocking it down to $1743. We paid 20% which represents the $348.48 above.

The GI doctor's fee was billed at $1050, but insurance knocked that down to $330. For some reason, we were not responsible for that charge and the insurance paid the whole $330.

So total charges were $3710 before insurance, $2073 taking into account negotiated insurance rates, and $348 out of my own pocket.

Note that the colonoscopy was clean so no polyps were removed, etc. Had their been any issues, I'm sure the cost would have been higher.
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no insurance--pricing a colonoscopy
Amount: $1,500.00
Posted by: Sandra LePage in Pasco, WA.Posted: February 1st, 2012 03:02PM
Clinic or Doctor: compared severalInsurance Carrier: none
Type of Policy: none
I don't have insurance, just turned 60, and haven't had a colonoscopy since I was 50. I had no colon problems at 50. I've called several gastroenterologists to compare the price of the procedure. I have saved enough money to pay for it, but don't want to pay more than I have to. A few offices I've phoned can't give me a quote because they only know the doctor's fee (between $300. and $700)and don't know the anesthetist's fee or the "facility" fee. Others have quoted me $1500 to $5000, and more if problems are found. It's just a screening and I'm tempted to skip it and use my savings to buy groceries and pay the power bill!
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colonoscopy
Amount: $3,800.00
Posted by: curtisL in sioux falls, SD.Posted: February 9th, 2012 08:02AM
Clinic or Doctor: sanford health,sioux fallsInsurance Carrier: assurant health
Type of Policy: 5000deductible
Have had insurance with this company for 20 years. Switched to "new" style policy in november,2011, to get screening colonoscopy as i am 57 and never had one. Even advised by thier phone agent to update my policy for these benefits.One polyp removed and you know the rest of the story-now is coded as preventative. My bill for full cost. I dont borrow money and have my house paid for so think i will just let my credit rating take a hit and not pay the bill-have never not paid a bill in my life--time to take a stand.
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Covered Under Preventative Care
Amount: $0.00
Posted by: Pre 60 year old screening in Houston, TX.Posted: March 6th, 2012 06:03AM
Clinic or Doctor: Mohan - North Cypress Hosp.Insurance Carrier: BCBS of Texas
Type of Policy: PCP
Outpatient - removed one polyp. BCBS was bille $7,078.88. Procedure done as a preventative screening. Covered 100%. No co-pay. No deductible. Cost to me - $0
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Colonoscopy
Amount: $25.00
Posted by: Tom M in Temperance Mi in Sylvania, OH.Posted: March 20th, 2012 10:03AM
Clinic or Doctor: FILIPIAK , CHARLESInsurance Carrier: HAP
Type of Policy: HMO
My colonoscopy bill $5,287 on March 16, 2012 Flower Hospital in Sylvania, Ohio It was really a big bill, glad I had insurance. Someone drove me home but no complications.
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Prior Colonoscopy w/ polyp removal not covered by insurance
Amount: $0.00
Posted by: Kate7 in Portland, OR.Posted: April 7th, 2012 10:04AM
There was a change in 2010 regarding what insurers will cover re: colonoscopies. The first one should be 100% covered as \'routine" or screening, but if anything (polyp, hemorrhoid, diverticulitis) is discovered/removed in subsequent ones, MOST insurers will not share the cost and patients are stuck with a big expense. My husband just had his second colonoscopy, was told by the nurse at Vancouver Clinic during the pre-op meeting that it would be covered 100% by our insurance (she knew his first involved polyp removal) but...three weeks later we got a bill of $2600. Clearly she mispoke and in retrospect, regardless of what the clinic told us, we should have doublechecked w/ insurance. Ask for a "predetermination" of benefits prior to a second procedure to ensure coverage amt. Again, not all insurers refuse to cover \'pre-existing\', but many will not.\r\n\r\nI
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colonoscopy
Amount: $12,000.00
Posted by: bprimiero in pittsburgh, PA.Posted: April 12th, 2012 01:04PM
Clinic or Doctor: mcgee womans hospitalInsurance Carrier: western & southern
Had colonoscopy done at mcgee woman\'s hospital. They did not contact my insurance before doing procedure. So my insurance did not pay anestiologist charges so I was billed 1,500 dollars for that. The hospital billed my insurance 9,000 dollars. With my 20 % copay they billed my another $1,500 dollars. So with insurance they want me to pay $3,000 dollars. I could have walled into 3 other local hospitals in the area for less then $2.000. I am not pay mcgee that\'s what u call over pricing an price gouging if I\'ve ever seen it in my life. My daughter had the same procedure done at st. Claire hospital one month before mine and it was less then $2.000. Is mcgee nuts r what. Now you know why the cost of insurance is so much.
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Colonoscopy in Sacramento
Amount: $2,000.00
Posted by: Mr. Lauren Lundsten in sacramento, CA.Posted: May 2nd, 2012 01:05PM
Clinic or Doctor: UC DavisInsurance Carrier: 1,000?
Type of Policy: Western Health Advan.
Procedure was painless until I received the bill. I'm 63. Monthly health insurance $540, my copay for the Colonoscopy $2000+ I'm feeling squeezed between the medical industry and the OIl companies. I have my own business and can't just raise the price or charge a service charge. I don't want the government in the mix. Unless they expand Medicare to age 60-64 group.
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