Colonoscopy (also called lower digestive endoscopy) is an endoscopic procedure that examines the lower digestive tract, consisting of the small intestine, colon, and rectum. It is performed following a specialist consultation and only on the recommendation of a specialist.
It is a safe method of diagnosis and treatment that brings useful information about the inside of the intestines. It is the best way to detect inflammation, ulcers, tumors, or other lesions of the lower digestive tract. In many states, colonoscopy screening after the age of 40-45 has become a common practice, being recognized as the best method of preventing colorectal cancer.
How Much Does a Colonoscopy Cost?
In case you don’t have health insurance, you should be prepared to spend anywhere between $2,100 and $3,800 for a colonoscopy, depending on the geographical area and the provider. According to the Blue Cross Blue Shield of North Carolina, the average cost of a colonoscopy is $3,100, without health insurance.
In general, the colonoscopy costs are covered by the health insurance as long as the patient has symptoms that prove the necessity of this procedure, or if he or she meets the risk and age criteria.
If you have health insurance, you should be prepared to pay nothing to more than $1,100 out of your pocket, depending on the copay, coinsurance, and deductible amounts. For instance, if you have Medicare coverage and choose to go for a colonoscopy at the Dartmouth-Hitchcock Medical Center you will have to pay around $1,500, including coinsurance and deductibles. Though, there are some health insurance policies like the Blue Cross Blue Shield of Michigan Community Blue PPO plan, that cover the proportion of 100% of the “wellness” screenings, with no copay or deductibles, but with some restrictions in general.
The colonoscopy is performed by the gastroenterologist, who inserts a device called a colonoscope through the anus, and then the endoscope advances along the entire length of the colon, sometimes to the last portion of the small intestine. The colonoscope is a thin, flexible tube that has a video camera and a flashlight with a bright light on top. The total duration of the procedure does not exceed 60 minutes. If necessary, biopsies of the intestinal mucosa may be taken during the colonoscopy, or fragments of tissue may be removed.
The patient will leave accompanied if analgesics or sedatives are administered and he will not be allowed to drive for 6 to 8 hours. If the patient is using an anticoagulant medication, they should consult their doctor to stop it.
At the doctor’s recommendation, the patient may be sedated and put to sleep during the procedure or may be induced into a relaxed state. Blood pressure and heart rate will be measured constantly during the examination.
What are the extra costs?
The costs may increase if during the procedure the polyps have to be removed.
Nowadays a new procedure is available, which is more expensive and is named “virtual colonoscopy”. This is an X-ray test that checks for colon cancer. Though, this cannot detect the very small polyps, that conventional colonoscopy can. This procedure is not considered an alternative to the conventional colonoscopy just yet.
Important things to consider
Make sure you ask your family doctor for a referral to a gastroenterologist. He or she should have a minimum of two to three years of training on the GI tract and be board certified in internal medicine by the American Board of Internal Medicine.
According to the American Cancer Society, the risk factors for colon cancer are a personal history of inflammatory bowel disease or a family history of the disease, along with being over 50 years old.
Your gastroenterologist may recommend a colonoscopy to investigate the causes of certain symptoms. Rectal bleeding, diarrhea, constipation, chronic abdominal pain, and unexplained weight loss are clinical manifestations that should worry you.
Colonoscopy is considered a routine procedure, however, very rarely, complications can occur such as bleeding, if a biopsy sample has been taken, bleeding after removal of polyps, or other abnormal tissue, a negative reaction to the sedative used, a rupture or perforation in the rectal or colon wall.
Is this procedure painful?
This is the question that concerns most patients and it is natural to be so.
Colonoscopy can be performed without sedation, with superficial sedation, or with general anesthesia. The last option involves the participation of an anesthetist and offers the best comfort for you and the doctor performing the procedure. It must be said that in most cases (8 cases out of 10) the procedure is painless, given the sedation.
How can I save money?
There are organizations, hospitals, and government programs that provide low-cost or free screening colonoscopy for all underinsured or non-insured patients. For instance, these programs are available in cities like New York City.
According to the Action Plan on Colorectal Cancer for the State of Texas and The Kentucky Cancer Consortium, you can undergo a flexible sigmoidoscopy to see if there are any problems with your colon. This procedure does not require sedation and can be done in a doctor’s office. This takes around 20 minutes or even less and costs anywhere between $110 and $320.
Though this cost may go up to around $1,600 if the procedure is done in a hospital, that will charge a facility fee. The flexible sigmoidoscopy has two main disadvantages: it should be done every five years instead of every ten years, and the doctor is able to see only half of the colon. There are studies that have shown that colonoscopy can detect pre-cancerous and cancerous lesions which a flexible sigmoidoscopy cannot. Though, the colonoscopy may be impractical to some due to the invasiveness and cost.