by Joshua Palmer

A colonoscopy may ultimately save your life, but is it wise to shop around for the best price?

For Angie's List member Linda Card of Indianapolis, the established relationship she has with her gastroenterologist far outweighs the cost. "I wouldn't consider a less expensive provider," says Card, who's undergone a colonoscopy. "When I find a doctor I'm comfortable with, I stay with them."

In contrast, Angie's List member Kerstin Buisson of Carmel, Ind., who's also had a colonoscopy, thinks consumers benefit from price shopping. "So long as the shopper makes sure all aspects have been covered," she says.

Dr. Gregory Lemmel, a highly rated gastroenterologist with highly rated Indianapolis Gastroenterology near Greenwood, says it's important to consider patients' comfort with their doctor. "The better relationship you have with your patient, the more you put them at ease, the better the experience for them," he says.

A colonoscopy, recommended every 10 years for most healthy adults over age 50, screens patients for potentially cancerous polyps. Of cancers that affect both men and women, colorectal cancer is the second leading cause of cancer-related deaths in the United States and Indiana, according to statistics compiled by the CDC in 2007.

Despite the risks, less than 50 percent of those who should be screened receive one, says highly rated gastroenterologist Dr. Daniel Stout, who operates Digestive Health Center in Carmel. And cost may play a role in that decision.

According to Healthcare Blue Book, prices for colonoscopies can vary by more than 300 percent in many areas. HCBB's published fair rate in Indianapolis is $436 for physician fees and $634 for facility fees for colonoscopies only. The fees increase if your colonoscopy requires a biopsy.

The fair price represents what a health service provider typically accepts from insurance companies as full payment, which is substantially less than the billed amount. For instance, Stout, whose office is a licensed ambulatory surgery center, charges about $2,000 total for both fees, but typically only receives $1,000 as the allowed insurance payment, according to his office manager, Jenn Fish.

Patients may also incur additional costs for referral or pre-procedure appointments, preparation materials to clear the colon, and fees for anesthesia or sedatives, which may be optional for some.

For Angie's List member Carolyn Tinsley of Carmel, the billed amount for a colonscopy at highly rated St. Vincent Women's Hospital cost $2,616 in facility fees and $880 in physician charges. She says her insurance covered both.

Kathy Anderson, director of the Indianapolis Endoscopy Center, not yet rated on Angie's List, declined to discuss specific prices, but confirmed that billed facility costs as high as $3,900 are within the typical range. She says IEC provides cost ranges to patients based on their insurance plans, but always with the caveat that costs may increase once a colonoscopy is underway. "It's hard to predict the total cost beforehand because you don't know what's going to be found during the procedure," she says.

Medical insurance generally covers a colonoscopy screening at 100 percent, Fish says. However, a colonoscopy becomes a diagnostic procedure for patients with symptoms such as blood in the stool, which often means higher out-of-pocket costs.