Here are five notes on colonoscopy costs:
1. Unadjusted and adjusted average reimbursement for GI procedures dropped by 7% and 33%, respectively, from 2007 to 2022, according to a study published in the American Journal of Gastroenterology. Reimbursements for colonoscopy and biopsy decreased by 38% during that period.
2. The average cost to undergo a colonoscopy in the U.S. in 2024 is $1,608, according to data from startup insurance provider Sidecar Health.
3. U.S. hospitals’ facility fees for colonoscopy procedures covered by private health insurance are an average of 55% higher than facility fees billed by ASCs, according to a JAMA Health Forum study published Dec. 15.
4. Here is a look at how the cost of a diagnostic colonoscopy changed each year at ASCs compared to HOPDs from 2018 to 2022, according to a brief from Blue Cross Blue Shield affiliate Blue Health Intelligence’s “Rising Prices for Hospital Outpatient Care”:
2018
ASCs: $980 (+3.9% from previous year)
HOPDs: $1,472 (+5%)
2019
ASCs: $1,010 (+3.1%)
HOPDs: $1,520 (+3.3%)
2020
ASCs: $1,011 (+0.1%)
HOPDs: $1,557 (+2.4%)
2021
ASCs: $1,022 (+1.1%)
HOPDs: $1,601 (+2.8%)
2022
ASCs: $1,040 (+1.8%)
HOPDs: $1,646 (+2.8%)
5. Here is the breakdown of colonoscopy costs in the U.S., according to Sidecar:
- Facility fee: 59%
- Gastroenterologist: 23%
- Anesthesia: 16%
- Lab fees: 2%
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