Type of the health insurance coverage (Deductible, PPO, Senior advantage, Open Access Plus, etc.) is the main determinant of the colonoscopy cost. This article gives you an approximate estimate of the cost you may have to incur for a colonoscopy procedure.
Colonoscopy is a medical procedure wherein a doctor or gastroenterologist examines the colon using a specialized flexible equipment known as a video endoscope. When the colon gets infected or injured, gastroenterologists need to know the root of the problem to recommend further appropriate procedure. This is a procedure that is used to check for any possibilities of harm to the large intestine. But nowadays, there is another procedure used for the examination, which is known as virtual colonoscopy. In this method, X-ray technology is used for determining any complications in the colon.
What Determines the Cost of Colonoscopy?
The overall cost largely depends on whether you are covered by a health insurance plan or not. Those covered under medical insurance for colonoscopy need not worry much about the cost, as most of it is taken care by the insurance itself. If you are covered for it, you would generally, be required to pay somewhere around $1,000. If you are not covered, the cost of a colonoscopy may range from $2,010 to $3,764, whereas the average cost of a colonoscopy, without health insurance, is approximately $3,081.
Deductible, Copayment and Coinsurance Status
It is suggested to get a good medical insurance plan after knowing the details of what would actually be covered under it. It is very important to know the difference between preventive or screening test and diagnostic test, and which expenses fall under deductible, copayment or coinsurance status. In fact, if you have a high deductible health plan, there are chances that you may have to bear the full cost of colonoscopy. There are, in fact, few health policies which cover you for the full cost of the treatment.
The cost of colonoscopy also depends on the type of surgical facility you choose to go. The facility and professional costs that are covered by the health plans differ for hospitals, ambulatory surgical centers and endoscopic centers.
Cost According to State and City
Colonoscopy procedure prices also depend on the state or city which you are undergoing the procedure in. Depending on the cost of living in that particular city or state, you may get it done at cheaper rates than it may require in some other costly places.
- If you are undergoing the procedure in Chicago, the procedure may cost you approximately $2,175.
- If you are choosing Milwaukee as a city to be operated in, you may have to pay $2,475.
- In Salt Lake City, Utah, you may have to shell out close to $2,025 for it.
Cost According to the Type of Procedure
Conventional or Virtual Colonoscopy
Another determinant of the cost is whether you are choosing the conventional colonoscopy procedure or the virtual colonoscopy. If you are choosing the latter one, you may be charged a little more than its traditional alternative. Clinical tests and examinations that are required to be done after the procedure may even add up to the aggregate cost. If during the procedure, doctors needs to take out tissues, this would not only add up to the cost, it will change the status of the procedure from screening or preventive test to surgery. The change makes it a totally different ball game when it comes to the total amount of the bill and how your insurance provider shares it with you.
If you are not in a position to afford to pay the cost and are also not insured, there are few federal government facilities, hospitals, and medical institutions which offer low-cost options or general screening to the exact colonoscopy procedure. ‘Flexible sigmoidoscopy’ is one such screening service provided. This procedure does not require the patient to be sedated and can be carried out in mere 20-25 minutes. Its cost generally, ranges from around $100 to $300, which, if you go to a hospital, can rise as high as $1,500, since the facility fee would also be considered in the aggregate cost. The negative point of this procedure is that doctors are able to view only a partial part of the colon. Moreover, it is also not effective as the actual colonoscopy. There are some people who, due to financial problems, may choose flexible sigmoidoscopy over conventional colonoscopy. If it is required, which can happen if you cannot at all afford the colonoscopy, you may like to inquire, in advance, about the forgiveness policies offered by the hospitals or a program called colonoscopy assist.
If you have subscribed to Original Medicare plan (since 2011), then it matters whether you visit a doctor who take assignments or not. The plan restricts charges for colonoscopy as well as for sigmoidoscopy, within the amount approved by this plan. Medicare Advantage (MA) is yet another plan initiated in 2012 which offers benefits on the line of Original Medicare plan, and prevents ‘in-network’ doctors from charging cost-sharing fees (coinsurances, copays or deductibles) for these procedures.
If you want to save on colonoscopy costs, it is recommended to undergo the procedure in a suburb instead of a metropolitan city. Whichever hospital or facility you choose, make sure that the physician is a board certified, to avoid colonoscopy risks and other colonoscopy complications as it will add to the expenses. If you have hardships in making complete payment at one time, you can ask at the medical facility for payment options or installment scheme.