Cancer risks outweigh the high price of colonoscopies
Despite the risks associated with not receiving a routine colonoscopy every five to 10 years, Angie’s List member George Hayles says the cost for the procedure might have precluded him from getting one.
The 67-year-old Spring Hill [Fla.] resident says insurance covered his recent colonoscopy, so he didn’t have to pay the nearly $1,300 bill. “Honestly, I probably wouldn’t have had it done [if insurance didn’t cover it],” Hayles says.
Of cancers that affect both men and women, colorectal cancer is the second leading cause of cancer-related deaths in the United States and Florida, according to age-adjusted statistics compiled by the Centers for Disease Control in 2007.
Routine colonoscopy screenings are key to preventive care. “They allow us to find and remove the pea-sized polyps that can grow into cancer,” says Dr. Lori Slezak, a highly rated colorectal surgeon in Tampa [Fla.].
The high price of a colonoscopy may prevent some patients with a high deductible or no insurance from getting the procedure, but Slezak says patients need to consider every option. “The cost shouldn’t deter patients from getting such an important exam,” she says.
According to Healthcare Blue Book, prices for colonoscopies may vary by more than 300 percent in many areas. HCBB’s published fair rate in Tampa is $470 for physician services and $634 for facility services. The fees increase if your colonoscopy requires a biopsy.
The fair price is what a health service provider typically allows from insurance companies as full payment, which is substantially less than the billed amount.
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 patients.
Depending on where she performs the procedure, Slezak says the same exam ranges from an allowable amount of $2,000 at an outpatient facility to $7,000 at a hospital, including both physician and facility fees. “The price isn’t really determined by the physician you choose, as much as where you have it done,” she says.
Dr. Robert Theobald, a highly rated proctologist in Tampa, says outpatient facilities typically cost less than hospitals because of the differences in overhead costs.
Other ways to save money include asking your insurance company to pre-approve a colonoscopy screening. “If you’re over 50 and it’s a preventive screening, most insurance companies will cover it 100 percent,” Slezak says. “But if you have symptoms and your doctor suggests a colonoscopy, you may be responsible for the bill.
”Theobald also suggests patients with no insurance or high deductibles pay for the procedure upfront. “There’s definitely an incentive to pay in cash,” he says. “Those savings can be 20 to 50 percent.”
Some patients also choose to forego anesthesia, although Theobald doesn’t recommend it for everyone. “You can expect to save about $300 or $400,” he says. “But it can be uncomfortable."