The typical costs of colonoscopy procedures vary widely, depending on a variety of factors. The cost for patients depends on whether you have commercial health insurance or Medicare, your individual plan, and where the colonoscopy is going to be performed (hospital outpatient department, surgery center, or physician’s office).
Many insurance plans, such as Anthem, United Health Care, and in the Tidewater area, Optima, cover colonoscopy as part of a “wellness” screening at 100 percent, with no deductible or copay. Other insurance companies may require a deductible based on the particular plan. Deductibles can range from zero to more than $1,000.
Our Total Cost for a colonoscopy including the nurse anesthetist is $850.00, significantly lower than any other gastroenterology practice in the Tidewater area and way below what you would be paying for the same procedure in a hospital outpatient department, currently as much as $5,500.00. If you do choose to take advantage of our lower cost, we ask you to sign a standard agreement stating that you won’t be billing through your insurance.
Determining the COST of your colonoscopy
There are many factors to consider when determining the cost of a colonoscopy. If a patient is asymptomatic, the results are normal, and the exam is considered ‘preventative’, there is no cost to the patient. However, if a patient is experiencing symptoms or a polyp or other pathology is found during the exam, the exam is may no longer be covered under preventative care and patients will likely incur some financial responsibility.
Patients with Medicare who also have a supplemental insurance (such as AARP, United, Anthem and others) usually pay no co-pay or deductible if the colonoscopy is done in the physician’s office. Some physician practices will only perform Medicare colonoscopies at hospital outpatient departments. This potentially raises the cost of the procedure, but it may still be covered by medical insurance.
Patients in the outpatient setting, without health insurance, typically pay $2,100 to $3,764, according to CostHelper.com. The average nationwide cost of a colonoscopy cost is $3,081 if you do not have Medicare or other insurance. There have been documented instances of patients being billed over $10,000 by hospitals for the use of their outpatient facility, even when the exact same procedure can be done in an office for a much-reduced cost. Some hospitals include ‘surprise’ charges in their fees that are not divulged up front.
Many physician owned office-based colonoscopy centers offer discounts if you don’t have any health insurance, or your insurance has a high deductible. Our practice offers a heavily discounted procedure rate in an effort to keep costs low and to make screening as accessible as possible, our practice offers a significant discount to patients who are uninsured and underinsured. There are no ‘surprise’ charges. The only exception to this rule is when a polyp or tissue biopsy is sent to a pathologist for testing. You may receive a separate bill from their office. The cost is typically under $100.00.
Things to Consider Before the Procedure
We recommend that if you are going to have a colonoscopy and are concerned about the potential costs (as most patients clearly are), do your research first and carefully consider the following:
- If you are having your colonoscopy in a physician’s office, your insurance company or the office should be able to check with your insurance company to determine if there will be any co-pay or deductible you will be responsible for.
- If you are told that the cost cannot be determined, look for another facility.
- If you are not insured or know your insurance will not cover all or part of the colonoscopy costs, ask the physician’s office for their ‘self-pay’ price. This is almost always substantially lower that the ‘insurance’ price or charge.
- If you are told that your procedure has to be done at a hospital facility, try finding another physician who can do your procedure in their office instead where costs are almost always substantially less and there will be no ‘surprise’ charges. With today’s modern anesthesia techniques and technology, very few patients ‘have’ to be done in the much more costly hospital setting.
- Go online and read Google reviews on the facility. Reviews are usually very honest and can give you a sense of how well patients are treated.
Why You Should Choose Us
We are one of the most cost efficient Gastroenterology practices anywhere in the Tidewater area.
Can you believe that a simple, easy procedure that takes less than 30 minutes could literally save your life? We do! In fact we know it can. If you want to make a world of difference for yourself, call and make an appointment now. And if you want to make a difference for someone you care about, we offer gift certificates for your convenience.
Most insurance plans in Virginia, including Medicare, cover most or all of the cost of colonoscopy since they consider colonoscopies an important preventative procedure. Center for Health and Cancer Prevention participates with almost all insurances, although there are a few which we do not. If you have any questions about your coverage, the best way to determine if you have any co-pay or deductible with your colonoscopy is to call your insurance company directly.
High deductible plan? No insurance? Not in network? No problem!
Did you know you can shop prices and get substantial savings if you don’t have insurance or have a high deductible plan?
One commitment we have at Center for Health is to make your colonoscopy screening accessible and affordable. Click here to learn more about colon cancer prevention on our blog and general news surrounding about colon cancer.