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.
If the procedure (colonoscopy) is done for a symptom or problem you have (such as bleeding or change in bowel habits), it may not be considered by your insurance company as strictly ‘preventative’ and you may be required to pay a patient co-pay and/or ‘deductible.’ This could be several hundred dollars or more.
Patients with Medicare who also have a secondary insurance (such as AARP, United, Anthem and others) will 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, potentially raising costs by as much as $4-5,000.
Patients 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 reduced pricing if you don’t have any health insurance, or your insurance has a high deductible. For example, the total cost for a colonoscopy at Center for Health & Cancer Prevention is $775 with no deductible or co-pay. There are no ‘surprise’ charges. The only additional charge (usually less than $100) would be the pathologist’s fee, only in the case a polyp or any tissue is removed during the colonoscopy.
In summary, I 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.
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.
Our Total Cost for a colonoscopy including the nurse anesthetist is $775.00, 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.