How Much Does a Colonoscopy Cost?

Last Updated on April 4, 2024
Written by CPA Alec Pow | Content Reviewed by CFA Alexander Popinker

Getting a colonoscopy is one of the most effective preventive measures against colorectal cancer. But like many medical procedures, it comes at a cost. This article will break down the key factors that influence colonoscopy prices and provide cost estimates to help you budget for this important screening.

A colonoscopy examines the full length of the colon and rectum using a tiny camera on the tip of a flexible tube. It’s typically recommended once every 10 years starting at age 45. The procedure lets gastroenterologists detect and remove precancerous growths before they turn malignant. Catching colon cancer early vastly improves survival outcomes.

Undergoing a diagnostic or screening colonoscopy is advisable, but patients are often worried about the potential colonoscopy cost. This article will demystify pricing, insurance coverage, and ways to keep your out-of-pocket expenses affordable.

How Much Does a Colonoscopy Cost?

Colonoscopy costs anywhere between $0 and $5,000+ depending on the hospital you’re going to, whether you are insured or not, and other factors. Here are some typical price ranges for a standard colonoscopy:

• At a hospital:
  • With insurance – $0 to $1,500+
  • Without insurance – $2,000 to $5,000+
• At an ambulatory surgery center:
  • With insurance – $0 to $1,000
  • Without insurance – $1,250 to $3,500

A colonoscopy diagnosis deemed preventive often has no out-of-pocket cost with insurance. Billing shifts to diagnostic when a polyp is removed and pathology ordered. This could mean you pay 20% of the total colonoscopy costs.

With a high insurance deductible ($2,000+) your responsibility could be $500 to $1,500 until you meet your deductible. Expect higher fees for facilities considered out-of-network.

ColonoscopyAssist.com offers colonoscopy procedures at a subsidized rate of $1,075 for uninsured patients. The price includes all costs related to the procedure, with no hidden charges or fine print. This includes physician fees, facility fees, sedation/anesthesia costs, removal of polyps, and pathology costs.

ClearHealthCosts.com reports that the cost of a colonoscopy can vary greatly, from $600 to over $5,400, depending on factors such as the location of the procedure, lab fees, anesthesia, and whether it is considered a screening or diagnostic procedure3.

MDsave.com provides colonoscopy prices starting at $1,540.

KQED.org reports that colonoscopy prices in the Bay Area range from $1,000 to $5,000.

Additional costs like anesthesia, biopsies, or polyp removal can add hundreds or thousands depending on your insurance particulars. Omitting sedation can save $150-$500.

What is Colonoscopy?

During a colonoscopy, patients are given intravenous sedation while the doctor inserts the colonoscope instrument to visually inspect the intestinal lining. If any polyps or abnormal tissue are found, they can be immediately removed during the procedure and sent for biopsy.

A colonoscopy takes 30-60 minutes. It is generally painless since sedation is used. To prepare the bowels for clear viewing, patients follow a liquid diet and take strong laxatives or enemas the day before. This bowel prep fully empties the colon.

The most common reasons to get a colonoscopy include:

• Colorectal cancer screening for adults age 45+
• Investigating intestinal symptoms like blood in stool
• Monitoring patients with a history of polyps
• Follow-up surveillance after previous colon cancer or polyp removal

A screening colonoscopy is considered preventive care under the Affordable Care Act when no symptoms are present. Diagnostic colonoscopies evaluate worrying symptoms and are billed differently.

You might also like our articles about the costs of HSG testing, HIDA scans, or urologist consultations.

Factors Influencing Colonoscopy Costs

The biggest variables affecting colonoscopy prices are:

• Insurance coverage – Insured vs. uninsured costs vary widely.
• Facility – Hospital versus freestanding surgery center.
• Location – Prices differ regionally based on local costs.
• Additional services – Biopsies, polyp removal, pathology exams all add fees.
• Type of sedation – General anesthesia costs extra.

Without insurance, total costs easily exceed $2,500. With insurance, out-of-pocket fees depend on your plan’s deductible, copays, and out-of-network particulars.

Insurance and Colonoscopy Costs

Health insurance handles colonoscopy coverage in several ways:

• No cost preventive screening – This applies to routine colon cancer screening colonoscopies. Deductibles and copays are waived with all ACA-compliant plans.
• Diagnostic procedure coinsurance – If a polyp is removed or biopsy performed, coinsurance typically applies. This means you pay 10%-50% of the total bill as your share.
• Deductible and copay may apply – If your deductible isn’t met, you pay out-of-pocket until reaching that amount. After deductible, copays or coinsurance apply.
• Out-of-network costs more – Seeing a provider outside your insurance network means you pay higher coinsurance and fees.

Medicare covers colonoscopies starting at age 50, or earlier with high-risk factors. $0 copay applies to the procedure every 120 months when considered preventive. Medicaid and ACA marketplace plans also cover recommended colon cancer screening at no cost.

How to Save on Colonoscopy Costs

If you lack insurance or want to minimize colonoscopy fees, consider these money-saving strategies:

• Ask if you can skip sedation to avoid those fees; it’s uncomfortable but lowers cost.
• Choose an ambulatory surgical center over a hospital – they often charge thousands less.
• Compare prices between different local providers to find the most affordable.
• If uninsured, negotiate payment plans or discounted cash rates.
• Seek out financial assistance programs from hospitals or charities.
• Enroll in an ACA insurance plan that covers preventive colonoscopies at no cost.

Preparing for a Colonoscopy

To prep for a colonoscopy, expect to:

• Follow a liquid diet for 1-3 days beforehand. Stock up on clear broths, juices, yogurt, and jello.
• Take a bowel prep solution to thoroughly cleanse the colon. Kits cost $25-$100, often covered by insurance.
• Arrange a ride home – you cannot drive for the rest of the day after being sedated.
• Take the day off work since you’ll be groggy and need to rest.

Proper prep makes all the difference in obtaining clear test results. Follow your doctor’s colonoscopy prep guidelines closely.

Final Words

A colonoscopy provides invaluable, potentially life-saving insights into your digestive health. While costs can range widely, insurance coverage and prudent choices help control your total fees. Shop around, understand your plan specifics, and don’t let expense deter you from getting this essential cancer screening. Colon health is worth the investment.

Frequently Asked Questions

Is a colonoscopy 100% covered?

Whether a colonoscopy is 100% covered depends on your insurance plan details and the exact reason for getting the colonoscopy. Here are some key points about full coverage colonoscopies:

• Preventive or routine colon cancer screening colonoscopies are typically 100% covered starting at age 45. That means no out-of-pocket costs at all.
• Diagnostic colonoscopies done to investigate symptoms like bleeding or anemia are covered differently, often subject to deductibles and copays.
• Procedures or biopsies during a preventive screening colonoscopy may change it to a diagnostic billing status. Then coinsurance fees apply.
• Medicare and Medicaid also cover preventive colonoscopy screening fully every 10 years, but coverage shifts for diagnostic colonoscopies.
• Some ACA marketplace insurance plans have copays for colonoscopies that waive preventive screening fees. But other plans don’t cover them 100%.

So in summary, only preventive colonoscopy screening gets 100% coverage. Once a polyp, biopsy, or other procedure occurs, costs are shared based on your specific insurance policy. Check your plan details to understand the billing practices for colonoscopies.

How much is a private colonoscopy?

The cost of a private colonoscopy at an outpatient facility without insurance averages $2,500–$4,000. Prices range based on the clinic, geographical location, doctor fees, anesthesia, and any additional services needed like biopsies or polyp removal.

Here are some typical private colonoscopy price ranges:

• Colonoscopy at private surgery center: $2,000–$3,500
• Specialist gastroenterologist fee: $800–$1,200
• Anesthesia or sedation fees: $150–$500
• Biopsy analysis: $150–$300 per sample
• Polyp removal: $150–$500
• Pathology exam: $500–$1,000

So expect a total private pay colonoscopy cost of $2,500–$4,000 on average when including the procedure, doctor, and facility fees. Extra services like biopsies quickly add a few hundred to a thousand dollars or more. Always get an itemized cost estimate in advance from the facility.

Some options to reduce private colonoscopy costs include choosing moderate sedation over general anesthesia or having a screening at a hospital with financial assistance. Shopping around for the best cash price can also help minimize the total fees.

Is colonoscopy prep expensive?

Colonoscopy prep kits are relatively inexpensive, typically ranging from $25–$75 when purchased from a pharmacy. Name brand kits like Suprep often cost more than generics.

The colonoscopy prep solutions are mixtures of laxatives and electrolytes that flush out the colon prior to your procedure. Insurance plans usually cover the costs of prep kits, since they are a required part of the screening.

With insurance coverage, colonoscopy prep kits end up costing $0 to $30 out-of-pocket on average. Even without insurance, the kits are fairly affordable at around $50–$75. So while unpleasant to take, colonoscopy prep solutions are not expensive.

The primary cost of colonoscopy prep is the over-the-counter clear liquids needed for the days leading up to your scope. But sticking with broths, juices, gelatin, and electrolyte beverages keeps additional food costs minimal. Saving on the prep is as easy as choosing generic laxatives over name brands.