Doctors recommend a colonoscopy usually around age 50, but sometimes sooner if they need to see the inner lining of your large intestine
While doctors often talk about the need for the colonoscopy, they rarely talk about the colonoscopy cost. If you don’t have insurance or have a high deductible, it’s important to know.
What does a Colonoscopy Do?
A colonoscopy is a tube that doctors use to look inside your intestines. It looks for inflammation, tumors, and ulcers. Sometimes doctors remove growths while in there, while other times they remove a tissue sample for biopsy.
Colonoscopies include anesthesia, doctors, and sometimes other services depending on what they find so it’s important to know the colonoscopy cost before you start.
What Affects the Colonoscopy Cost?
A few factors affect how much a colonoscopy costs:
- The location of the procedure – If you’re already in the hospital and need a colonoscopy, it may cost more as hospital procedures cost more than outpatient procedures.
- The procedures performed – If the doctor needs to remove tissue or a growth, there are extra costs involved
- Your location – Different areas of the country have higher healthcare costs than others
- Insurance – If you have insurance, the medical facility may have contracted rates with the insurance company, which means less money out of your pocket if you have to contribute
The Average Cost of a Colonoscopy
The colonoscopy cost ranges from $1,250 – $4,800, with the average cost around $2,750. The higher prices are for patients having the colonoscopy in the hospital or who need more assistance with the procedure (more medications or supervision).
Does Insurance Cover a Colonoscopy?
The Affordable Care Act made it so insurance companies must cover a colonoscopy, but there’s a loophole. The United States Preventative Services Task Force recommends colonoscopies starting at age 50. Insurance companies including private companies and Medicare cover them at this age. They consider it a preventative service, which means most insurance companies cover them at 100%, but usually only the screening itself.
A colonoscopy often including other services, such as anesthesia and the removal of polyps or tissues, which insurance may or may not cover.
In addition, if your doctor recommends a colonoscopy before age 50, your insurance might or might not cover it or may apply it toward your deductible because it’s not ‘recommended’.
In-Network and Out of Network Insurance
If you have insurance, you’ll lower the cost of a colonoscopy if you stay in-network. Contact your insurance company to find out not only which doctors, but which outpatient facilities or hospitals are in your network.
If you go outside of your network and the insurance company doesn’t cover 100% of the procedure, you may owe a higher percentage of the procedure’s cost than if you stayed within your network.
Other Colonoscopy Costs
In addition to the procedure itself and the anesthesia, other costs play a role in the total colonoscopy cost:
- Cost of the prep medication
- Doctor’s fees for diagnosing the issue and creating a treatment plan
- The type and length of anesthesia or chosen sedation
- Any tests necessary after the procedure, including biopsies
- Any miscellaneous charges the facility or hospital charges
Saving Money on a Colonoscopy
Saving money on a colonoscopy is easy with these steps:
- Make sure you see a doctor in your network
- Make sure the hospital or facility is within your network
- Ask about the possibility of having the procedure in an outpatient facility, not a hospital
- Know the cost of ‘other procedures if they find something during the colonoscopy
There are several ways to prepare for the cost, such as creating an allocated spending plan.
Know your Colonoscopy Costs Before Having the Procedure
There’s nothing worse than a surprise medical bill to the tune of thousands of dollars. Knowing the colonoscopy costs before you have it done helps you plan. Look around for doctors with cheaper costs if your insurance won’t cover it, or if you don’t have insurance and/or work out a plan with your doctor.
Many doctors offer discounted services if you pay for the service upfront and in cash. Since most insurance companies only pay doctors a fraction of their charges for colonoscopies, they can offer the same benefit to patients like you that don’t have insurance. It doesn’t hurt to ask and if they say no, look elsewhere.