A colonoscopy is a procedure done by a doctor to determine irregularities in the colon. The out-of-pocket costs of a colonoscopy can range between $1,250 to $4,800. There are several factors that influence the cost of the procedure; one major factor being where the procedure is done. Outpatient facilities are a lot less expensive compared to inpatient facilities.
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The Cost of a Colonoscopy
The cost of a colonoscopy ranges between $1,250 to $4,800 and the average cost is $2,750. Below you can find the average costs nationally and the target fair price.
- National Average: $2,750
- National Range: $1,250 – $4,800+
- Target Fair Price: $2,450
The price of a colonoscopy will vary depending on what city and state you get the procedure in. As you can see in the table below, the cost in Los Angeles, CA is the highest of the markets we have data on, while the lowest is Atlanta, GA.
The Cost of a Colonoscopy by City
|City and State||Price Range (via newchoicehealth.com)|
|Atlanta, GA||$925 – $3,000|
|Chicago, IL||$1,000 – $3,300|
|Dallas, TX||$950 – $3,100|
|Houston, TX||$950 – $3,100|
|Los Angeles, CA||$1,400 – $4,600|
|Miami, FL||$1,000 – $3,300|
|New York, NY||$1,100 – $3,700|
|Philadelphia, PA||$1,100 – $3,500|
|Pheonix, AZ||$1,000 – $3,300|
|Washington, DC||$1,050 – $3,500|
The Cost of a Colonoscopy Based on the Facility
Colonoscopies can be performed in an outpatient or inpatient facility. Outpatient facilities, such as a clinic, don’t require hospitalization and are also known as ambulatory care. Inpatient facilities, such as hospitals, require admission and usually a brief or extended stay.
- Outpatient Facility Average: $2,550
- Inpatient Facility Average: $4,350
As you can see, the inpatient facility average cost is 41% higher than the outpatient facility. Therefore, it’s important to understand where you will be receiving the procedure and whether or not you can afford the cost.
Factors That Influence the Cost of a Colonoscopy
The cost of colonoscopies varies depending on the facility in which you are receiving the procedure, your location, prescriptions (such as pain killers or sedatives), and additional office visit costs.
The factors that influence the cost of a colonoscopy include:
Facility Cost: As previously mentioned, the facility in which you receive your colonoscopy will determine how much it will cost you. The reason colonoscopies are so much more expensive at inpatient facilities is that hospitals are very expensive to run, and if you have to stay for an extended period of time, the costs will accumulate.
Location: If you live in a city such as Los Angeles, CA, you can expect to pay the highest price in the U.S. compared to other major cities. You may want to consider getting the procedure done outside of the city, in order to save money in a location that may cost you less. You should inquire with your doctor about this and you can also call different facilities about their pricing.
Prescriptions: Nearly all colonoscopies performed in the United States will include some level of sedation or anesthesia. Most of the time, patients will be asleep for the procedure. Because of this, you may be faced with additional prescription costs. If this is a concern, you should communicate with your doctor and ask if there are generic versions that can be used to lower the cost.
Additional Office Costs: If you receive an initial consultation before your procedure, this will incur additional costs if it’s not included with the colonoscopy. Healthcare providers may also request a follow-up visit after the colonoscopy to go over your results. You should ask your doctor if these visits will be included in the total cost of your procedure.
Colonoscopy Frequently Asked Questions (FAQ)
When it comes to getting a colonoscopy, there are many questions patients might have. Below we outline some common questions about colonoscopies.
What’s the purpose of a colonoscopy?
A colonoscopy may be done for the following reasons:
- Investigate intestinal signs and symptoms. If a patient is experiencing pain and other symptoms, such as abdominal pain, rectal bleeding, chronic constipation, chronic diarrhea, and other intestinal problems, a colonoscopy can help your doctor explore possible causes.
- Screen for colon cancer. If you're age 50 or older and at average risk of colon cancer — you have no colon cancer risk factors other than age — your doctor may recommend a colonoscopy every 10 years or sometimes sooner to screen for colon cancer. Colonoscopy is one option for colon cancer screening. You can talk with your doctor about your options.
- Look for new or additional polyps. A polyp is a small clump of cells that forms in the lining of the colon. If you have had polyps before, your doctor may recommend a follow-up colonoscopy to look for and remove any additional polyps, which can reduce your risk of colon cancer.
How does a colonoscopy work?
A colonoscopy takes about 30-60 minutes and works by having a long, flexible tube called a colonoscope, inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon.
The scope is long enough to reach the entire length of your colon and there’s a light and a tube (channel) that allows the doctor to pump air or carbon dioxide into your colon. The air or carbon dioxide inflates the colon, which provides a better view of the lining of the colon.
The doctor can also insert instruments through the channel to take tissue samples (biopsies) or remove polyps or other areas of abnormal tissue.
Where should I get a colonoscopy?
When determining where to get a colonoscopy, it will depend on if your doctor referred you to a facility, your location, and how much you’re willing to spend out of pocket for the procedure.
According to Dr. Jacob Tiab, MD at My Leukemia Team, “[Colonoscopies] are usually conducted by a gastroenterologist or colorectal surgeon and can be performed in a hospital or outpatient surgical center. It usually does not require being admitted to the hospital after the procedure is completed.”
If cost is a concern, you may want to call facilities near you and ask about the price of the procedure. If you have insurance, you can ask the facility if your insurance is accepted and if there will be any additional costs.
Do I need a doctor referral to get a colonoscopy?
Patients may not always need a referral to get a colonoscopy. If you don’t have any serious medical conditions, you may qualify for a Direct Access Colonoscopy. Direct Access Colonoscopy allows for the healthcare provider to refer patients to a healthcare practice without a full gastrointestinal specialty consultation. They are particularly appropriate for healthy patients who need a routine screening colonoscopy but have no serious medical conditions. However, the patient must qualify.
Direct Access Colonoscopy is recommended for:
- Asymptomatic healthy individuals greater than 45 years of age
- Individuals with a family history of colon cancer greater than 40 years of age
- Individuals with a personal history of colon polyps
- The goal of our program is to work with you and our area PCP’s to help streamline the colon screening referral process while minimizing cost and inconvenience for patients who are in need of a colon screening, not a consultation.
If you do not meet the qualifications for Direct Access Colonoscopy, you likely need to consult with your doctor to schedule a consultation for a referral.
Who should get a colonoscopy?
According to Dr. Tiab, “Both men and women face a lifetime risk of 6% for developing colorectal cancer, so it is important to start screening at 50 years of age. While it is recommended to screen once every 10 years, certain patient groups, such as those with a family history of cancer in a first-degree relative or a hereditary tumor disorder of the colon, may need more frequent screening and follow-up to detect tumors at an earlier stage.”
Additionally, you should have a colonoscopy if:
- You get a positive result on another colorectal cancer screening test. If you get a positive result on another colorectal cancer screening test, this means that you will need to have a colonoscopy in addition to the test.
- You are having symptoms of colorectal cancer. If you are having symptoms of colorectal cancer, your doctor will need to do a colonoscopy to find out more about your condition. Colorectal cancer symptoms include Rectal bleeding, dark-colored stools, blood in your stool, diarrhea or constipation that lasts for several days, etc.
Colonoscopies are essential for men and women to get, especially if they are over the age of 50 and/or at risk for colon cancer. It can be a costly procedure, especially if you are uninsured. However, there are ways to control the cost, such as going to an outpatient facility, being aware of your location and how it impacts the cost, and asking about generic prescriptions for sedation.