With Insurance Coverage: Copay, Coinsurance and Deductibles
High: Without Insurance Average $3,081
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[1] .
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 2012 Colorectal Cancer Legislation Report Card[2] , 31 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[3] would pay $1,477, including deductibles and coinsurance. However, some insurance plans, such as the Blue Cross Blue Shield of Michigan[4] 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[5] has an overview of the procedure.
The American Academy of Family Physicians[6] 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[7] .
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[8] 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[9] 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[10] .
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.
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Posted by: Tex—in the Philippines (Bohol Island) in Tagbilarian Philippines, Other.
Posted: February 16th, 2022 02:02PM
Clinic or Doctor: Ace Medical Center Tagbilarian Bohol Phi
Insurance Carrier: None
Type of Policy: None
Cost covered 2 nights in Hospital - The Procedure ( 1.5 hours ) Anesthesia ( the best & No Pain ) all additional meds. I thought I got ripped offf. But after reading all these stories ( I feel pretty good- I guess eggs are cheaper in 3rd world country ). Sad news they found 14mm tumor, the test results should be back in 4 days. Wish me luck!
Total cost with anesthesia and everything else they could tack on was MORE THAN NINE THOUSAND DOLLARS. My cost after insurance was $1,300. This is why people die of colon cancer.
I am Colonoscopy shopping since my wife is 58 and had the baseline scope done at 50. We have a high deductible with PHCS/Medishare so it will be out of pocket whether we do it this year or next. The costhelper notes overview states "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". But I am amazed at the huge cost ranges that I see in these comments. Does anyone have any recommendations for how to negotiate a c-scope? Plus, what are charges that might slip through the cracks if I don't know or ask about them?
I called my insurance and I will be expected to pay 20%. No accurate amount can be figured ahead of time. Due to a possible health issue, it has to be done in a hospital versus gastro center. Therefore, it will cost 2x-3x more. Until I can have it done at the gastro center, I shall wait.
'List Price' was $2400 Dr. + $9600 Hospital; I pre-paid so got 75% off. Was called for a 3 year recheck (had 2 polyps removed, 1 pre-cancerous) and 2017 Dr. 'list' was $3200, no price from hospital as yet.
If you have no Polyp you are covered . If you have a Polyp it could cost you $3000. Know your codes before you see a doctor. Any information you give to your carrier can and will be used against you.
Hospital/insurance rip-off's! I thank God for Tricare. Recently had a Colonoscopy, bill was $5400 (everything included), Insurance paid $640, I paid 0! Ask first how much it cost as it can be reduced. You may be required to pay 20%, WOW that's still more than the procedure! Its a shame how people are screwed over so much!
Posted by: Insured but not covered in San Antonio, TX.
Posted: October 23rd, 2016 03:10PM
Clinic or Doctor: San Antonio Gastro
Insurance Carrier: United Heath Care
Type of Policy: Gold Plan w/$3K deductible
Description: Charge: Patient Bal: Colonscopy, $1200 $336.52 one sm polyp Anesthesia $700 $258.30 Level IV Path $225 $56.87 (lab) 55 years old, first "preventative" screening. Date of procedure, August 2016.
Posted by: Health Alliance Plan Rip Off For Colonoscopy in Troy, MI.
Posted: September 24th, 2016 03:09PM
Clinic or Doctor: Dr. Weber
Insurance Carrier: Health Alliance Plan
Type of Policy: Medicare Advantage
I went for a colonoscopy screening. I called my insurance company who informed me "It was covered." The doctor found and removed one polyp on the screening. This then changed the bill to over $600.00 out of my pocket. I challenged the bill and my insurance denied me. It was a screening. The doctor had to use the same anesthesia, same room, same time except for the 5 minutes he removed the polyp and because of a small polyp HAP insurance charged me over $600.00. HAP is a horrible company. They should honor what they told me when I called them. There is no lawful justification for this $600.00 charge except to rip off the medicare recipient. And, absolutely never again will they have the ability to bill me for a colonoscopy because I will never get another colonoscopy.
Impossible to get (actual) cost with any assurance of accuracy. I am 84. Suggestion is that UNH-Medicare will not pay. Cannot verify. Everyone in medical system "Runs for Cover" will not answer. Disgusting.
Clinic or Doctor: GI ASSOCIATES OF ROCKLAND COUNTY,NY
Insurance Carrier: FIDELIS
Type of Policy: Medicare Advantage
Procedure completed expertly.No discomfort whatsoever.Worst part is taking Gatorade/miralax prep,and that not as bad as expected. Here's the paperwork: Total : $1,550.00 $615.11 $934.89 12/21/2015 12/21/2015 Z1211 9920325 N $150.00 $26.87 $123.13 12/21/2015 12/21/2015 Z1211 A4550 N $300.00 $100.00 $200.00 12/21/2015 12/21/2015 Z1211 45385 N $1,100.00 $488.24 $611.76
Total is $1,500,and paid by Fidelis.I owe 10.00 fee for specialist. I may get a lab bill for biopsy,and for anesthesia surcharge,but Medicaid gave me monthly spend down coverage that should cover charges.Keep you posted. Highly recommend GI ASSOCIATES OF ROCKLAND.Painless and no after effect,and I lived to tell about it.
Insurance Carrier: Humana Medicare Advantage Gold Plus
I was already diagnosed w/ IBS, am on SSDI, needed 2nd opinion diagnostic colonoscopy. I about fainted when I received the insurance company's monthly report showing they were billed $12,000. one polyp was removed, but what the heck? My open hysterectomy & 2 day stay in the same hospital was only $16,000.
Does not make sense that these insurances do not cover the colonoscopy if it is considered diagnostic. Other tests to provide a diagnosis are mostly covered. My daughter is under age 50 and had symptoms that a doctor recommended the procedure. Now her co-pay is over $700. I was charged more when I had mine because I had a polyp. Insurance companies are a racket and out of control.
Clinic or Doctor: Piedmont Newnan Hospital, Georgia
Insurance Carrier: United Healthcare
My husband (44 yrs old) had a colonoscopy for minor GI symptoms. His PCP told him it would be covered by insurance because there was sufficient documentation regarding his GI problem. The colonoscopy literally took 20 minutes. The hospital billed $10,423, anesthesiology billed $1600 and we have not received the surgeon's bill who actually did the procedure thus far. Our portion so far has been $2000. I am LIVID!! We pay $500 per month for our insurance policy and consider UHC one of the best insurance carriers. It is terrible to be under the impression a procedure is going to cost $50 co-pay and end up with a bill for thousands of dollars!! UHC told us in the future get all of the procedure codes before and run it by them. If the situation is not an emergency we will be doing that in the future.
This was what is was like before big brother got involved in our Medicare I was 32 yo at work and started bleeding Took to hosp bleeding stopped scheduled me for colonoscopy in one of the best hosp in Ca. Did test had stage 3 rectal ca. Have me 12% chance 5yrs. Here's catch I'm still here yeah! My 2 sons age 27 and 28 are way overdue for colonoscopy as told by my GI because of my extremely young age and being a first gen relative. Ins says no not pay until 50. That is what our leader has done for us read the horror stories The govt has no business in medical care at all it wasn't perfect or cheap but it was 100x better than now. God bless u all
I need to have my first colonoscopy since I'm age 58 and long overdue. Was told by my insurance company, when I called to check on coverage a head of time, they will pay a simple first time colonoscopy at 100 percent. BUT...if they find anything, it's then considered "surgery". At that point, the costs are "anybody's best guess". I'm just thinking, REALLY?!! In this day and age. I agree with some others who've posted here, when you go into the hospital or clinic with NO IDEA of what you will owe when you come out of a routine procedure, well, it's crazy!!
My Dr forgot to set up a anesthesia and my Dr told me he could give me something that would put me to sleep. It didn't work. It was horrible and extremely painful and I was begging them to stop, screaming and crying. The nurse told me to shut up and quit being a baby. My Dr said he was almost finished but it went on for another 15 min at least. I was completely traumatized and didn't say anything to my husband until after we left. The next day I called the hospital and told the customer service what happened. They apologized over and over and I didn't pay anything. They took what medicare paid them and didn't bill me for anything. I have not had another done since even though I had a cancerous polyp removed. I wish now I had sued the hospital since I still have flashbacks of that mess they did. Never do a colonoscopy without anesthesia is my advice.
I paid $1800, insurance paid rest. I asked for ballpark estimates prior to, sorry depends on the billing codes. Do recommend colongraphy on a first pass, most people do not have polyps and you get an overall screen of the abdomen that has implications beyond cancer. Done at MD Anderson, surprised by some of the fumbles. Wrote a complaint. I am not done with this investigation, the price was too high, and the insurance company did not seem to care. Will be shopping around next time.
At first I was told my colonoscopy screening would be covered at 100%. However, UHC has since told me that they won't cover it because I hadn't turned 50. My primary care physician wanted me to have the preventative screening because of a family history of colon cancer. I paid $400 facility/surgery center fee, $700 for the doctor's fee which included light sedation, and $200 for labs (I assume for the pathology on the polyps that were removed). The ACA guidelines now say that an initial screening over age 50 has to be covered at 100% even if polyps or anything else is found. All future colonoscopies however will be considered diagnostic. The issue I'm having is whether a high risk patient can get their insurance to pay for the screening before age 50.
I did my homework or so I thought....and was totaled inclucding facility anestesia dr and pathology aprox 400 out of pocket. Now finding out all 4 oop cost total almost 1000$....I pay 200 a month and have to still pay this....sickening when you find out peeps without insurance are charged so little. April of 2015 was my proceedure and I had 8 polops
10 year old daughter had to have colonoscopy/endoscopy. Procedure done at same time. Hospital cost, before insurance $15,000. Insurance allowed cost was $6900. I have a $5000 deductible. Only part of my deductible had been met for the year so cost to me was $3900. THIS IS NOT INCLUDING PATHOLOGIST AND ANESTHESIOLOGIST. Apparently, if the procedure was "routine", meaning patient over 50, colonoscopy would be covered 100%. The hospital bill is shocking. Why am I being charged 2xs for the room?
I run a GI center in Portland Maine "Maine Centers for Healthcare". We give patients with no insurance a cost of $850 + reasonable lab costs..... if even needed. I'm seeing prices here of $10,000 for the same procedure. I can't believe what I'm reading. This is abuse.
Clinic or Doctor: Franciscan Digestive Care of Tacoma
Insurance Carrier: None
Type of Policy: None
I tried to pay everything in advance for my wife's procedure to get the greatest discounts. We were charged $2284 on the day of the colonoscopy and were told that was an estimate--we could be charged more or have some refunded. They found a polyp, and we had to pay an additional $548 for the removal and lab fees. The cost for removal and lab fees would have been higher, but some of the initial payment was credited toward this. I guess this is in line with others have paid, and there are only two clinics in the area that do this procedure, so I wasn't able to do much shopping around. Maybe next time I will do some comparison shopping at clinics outside the region, but I'm not optimistic I will be able to save much. I think I'll try this company to see if they can find me a better price: http://medibid.com/
Clinic or Doctor: Torrance F*cking Memorial, Torrance CA
Insurance Carrier: United Healthcare
Type of Policy: PPO
$10,016.26 for the Exam, "Surgery" and Lab work. $760 for the Anesthesia. $2,804 for the Doctor's specific work. I will not need to pay all this but easily accumulated to the $2,500 out of pocket maximum. But really how did this all cost over $10k I just don't understand? This was all after a scare of pain on my lower left side. My regular doctor ordered it as a "precaution" and here I am again in debt thanks to healthcare costs.
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