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COST

How Much Does A Colonoscopy Cost?

At Center for Health and Cancer Prevention, if you pay for the procedure on the day it is done, we apply a same-day discount that is much less than you would pay at the hospital or most other practices (when we last checked we were the lowest cost in the US). This discount is applied for anyone that pays for the procedure the same day, be they insurance companies, patients with insurance, or patients that have no insurance.

The full cost for a procedure, with the discount applied, is $975.00 and that includes the physician charge, the facility charge, the anesthesia, and the nurse anesthetist.

The only thing not included in the cost would be the cost of the lab should we find something during the procedure and need to have it tested. In that case, it would be an additional $65.00 per test. This is done through a separate business called Pathology Laboratory (or Aurora Diagnostics), and you would receive a separate bill from them after your procedure was complete.

Fortunately, in Virginia, if you have COMMERCIAL INSURANCE, like one of the companies noted above, the answer to that question is likely “nothing,” if you are getting a screening colonoscopy once every 10 years. This is because state law in Virginia requires state insurance companies to cover ‘preventative services’ (like screening colonoscopies) at 100%. While there are exceptions (see below), for most of our patients, a screening colonoscopy is completely covered.
  • If you are getting a colonoscopy sooner than 10 years, even if it is just for preventative reasons such as personal or family history of colon cancer, your insurance company may not cover the full amount of your procedure and might put some, or all, of the procedure cost towards your deductible.
  • If you have Medicare and have a screening colonoscopy, but we find a polyp (a small clump of cells that may or may not be cancerous) or take a biopsy during the procedure, Medicare considers the procedure to be diagnostic and will cover everything except for 20% of the procedure cost, which will then go towards your deductible.

If you have Medicare, your colonoscopy is also likely to be at no cost to you, unless you have one of the exceptions listed above.

If you have a secondary, or supplemental insurance, in addition to your Medicare plan, you will likely not have to pay much, if anything, even if a polyp or biopsy is taken.

This depends on how much of your deductible has been met and what your out-of-pocket max is through your insurance plan. The best place to start would be with your insurance company as they would be able to give you the most in-depth information.

If you wanted to pay on the day of your procedure to have the same-day discount applied, that would be an option. By choosing this option, you would sign an agreement (called the Hi-Tech Act) not to send any claims to your insurance company to be reimbursed. Also, you cannot use the cost of your procedure against your insurance deductible.

A screening colonoscopy is a procedure that is done once every 10 years to check for colon cancer. If you have had colon cancer or colon polyps in the past, or if you have family members that have had, or have, colon cancer, or have other risk factors that increase your risk for colorectal cancer, you may need to get a screening colonoscopy done sooner than every 10 years.
A diagnostic colonoscopy is a procedure that is done to find out, or diagnose, where a problem is coming from. For example, if you notice blood when you wipe after going to the bathroom or are having difficulties going the bathroom, your doctor may recommend a diagnostic colonoscopy to check for colon cancer.

Nowadays, virtually all straightforward diagnostic and screening colonoscopies and EGDs are done in physician offices if you are a reasonably healthy person at average risk. If the office you are considering tells you that you need to have it done at the hospital, without a good reason why, you may want to seek a second opinion to be sure.

The cost of doing a colonoscopy or EGD in the hospital is much higher. It could be as much as $6000 – $8000 once all the fees are applied and is generally not necessary unless there are specific reasons.

If the practice you are considering cannot give you a cash or time-of-service price, look elsewhere to have a colonoscopy. We highly recommend that you go online, and read Google reviews on the facility you are considering. Reviews are usually very honest and can give you a sense of how well patients are treated.

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TESTIMONIAL

Our Happy Patients

Our commitment to our patients shows in our reviews!

June M

A few weeks ago I visited your office for a long overdue ‘routine’ colonoscopy. I was surprised how painless and unembarrassing it was. To my surprise, Dr. Berger told me he found a large polyp that he was able to remove. Yikes! Thank God everything turned out okay, but I am extremely grateful to you and your fantastic team (thanks Linda!) for helping me through this! You are all wonderful!

Sylvia B.

A sincere thanks to all of you for being so nice when I had my upper endoscopy. Words can’t express my appreciation to Dr. Berger for his understanding and patience. . . I delayed having this procedure for a long time, knowing this would be a problem – maybe insurmountable. I was so embarrassed at my difficulty, but you . . .solved the problem. You’re terrific and I am grateful.

Buck H., M.D.

PLEASE tell Dr. Berger how much I appreciated his efficiency and painless procedure. And tell his IV nurse that that was the most painless IV that I ever had. I was so impressed with all of you.

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