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Doctors recommend a colonoscopy procedure when they need to visualize the inner lining of a patient’s large intestine.
The test uses a colonoscope — which is a flexible tube — to find signs of inflammation, ulcers, polyps or tumors. Doctors also can remove abnormal growths, take samples of the tissue to biopsy and check for other signs of disease.
Before patients undergo a colonoscopy procedure, doctors provide all the necessary information about preparing for the test.
Although learning about what to expect during a colonoscopy procedure is a common part of the conversation between doctors and patients, patients rarely hear much about what to expect to pay for a colonoscopy before the procedure.
So, how much does a colonoscopy cost? Read on to learn more about the costs and factors that affect it.
Colonoscopy cost factors
Many different factors affect the final cost of a colonoscopy. Examples include:
- Geographic location: Health care costs vary by location and region.
- Health of the patient: Very ill patients typically have the procedure in a hospital, which costs more than outpatient facilities. High-risk patients may need additional resources.
- Where the physician performs the procedure: Outpatient surgery centers typically charge less than hospitals.
- Whether the doctor removes tissue samples.
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Average cost of colonoscopy procedures
The typical costs of colonoscopy procedures vary widely, depending on a variety of factors. The cost for patients also depends on whether they have health insurance. Here’s a rundown:
- Patients without health insurance typically pay $2,100 to $3,764, according to CostHelper.com. The average colonoscopy cost is $3,081.
- Patients with health insurance pay deductibles based on their plan. Deductibles range from zero to more than $1,000.
- Patients with Medicare typically pay around 20 percent of the Medicare-approved amount for the physician’s services, in addition to making a copayment on the outpatient facility charges.
Common charges during a colonoscopy procedure
The physician’s charge is only part of the total amount you may pay for a colonoscopy procedure. Additional charges associated with the cost of a colonoscopy include:
- Colon prep kits: Hospitals commonly provide these; some doctors provide them while others instruct patients what to buy.
- Differing fees for diagnosis: Charges may differ depending on whether the colonoscopy is for cancer screening, diagnosis of symptoms, colonoscopy with a biopsy, or a colonoscopy with removal of a lesion or polyp.
- Sedation: The type of sedation, and whether an anesthesiologist administers it, affects the total cost.
- Pathology: Cost of examining abnormal tissue removed after a colonoscopy.
- Facility charges: In addition to the physician’s bill, the hospital, surgery center, or physician’s office may charge extra for use of the exam space.
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Colonoscopy cost and insurance coverage
How much does a colonoscopy cost for patients without insurance? They typically pay 100 percent of the charges for this test.
The amount patients with insurance pay depends on the contract between the patient’s insurance carrier and medical provider. Choosing in-network providers typically offers the lowest patient cost, while choosing out-of-network providers frequently results in higher patient deductibles and out-of-pocket expenses.
Virtual colonoscopy cost
Virtual colonoscopies use computed tomography (CT) or magnetic resonance imaging (MRI) to create a three-dimensional image of the large intestine. Experts are continuing to study this less-invasive method to determine whether the results are as accurate at traditional tests.
Virtual colonoscopy procedures typically carry a lower cost than traditional colonoscopy procedures. For example, in 2015, Medicare estimates revealed an average cost of $1,036 for traditional colonoscopy procedures. That same year, the cost of a virtual colonoscopy averaged $439. Medicare estimates that virtual colonoscopy procedures cost 29 percent less than traditional procedures.
Additional colonoscopy cost considerations
Some hospitals, organizations and government programs offer low-cost and free colonoscopy screenings for uninsured or underinsured patients.
Depending on the patient’s condition, doctors may recommend a flexible sigmoidoscopy instead of a colonoscopy. This procedure can be performed in the physician’s office, typically within 20 to 30 minutes. It doesn’t require sedation and usually costs around $200.
Doctors can only view half the large intestine, so it may not be a good option for everyone.
Choose a board-certified gastroenterologist to perform the procedure. Whenever possible, minimize the cost by choosing a provider who participates with your insurance plan and work closely with your doctor to determine how frequently you need to have the procedure to better anticipate costs.
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