high colonoscopy bill

(Updated 2022) “At age 62, Cedric Valeary had yet to get a colonoscopy to screen for signs of colorectal cancer – the second deadliest type of cancer in the United States. During his annual check-up in December, his doctor told him it was time,” Jed Lipinski writes over at our partner, NOLA.com I The Times-Picayune in New Orleans, part of our “Cracking the Code” partnership.

“Valeary, a building engineer in New Orleans, was in good health, with no symptoms in need of diagnosis, he said. Under the Affordable Care Act, insurance plans must cover in full the cost of preventive services like colonoscopy screenings, even if you haven’t met your deductible. Entering the examination room at Tulane Medical Center, Valeary was confident he wouldn’t have to pay too much.

“He was mistaken. A month later, he received his explanation of benefits from Blue Cross and Blue Shield of Louisiana, stating he owed $1,079 in doctor and facility fees. A few days later, a bill arrived from Tulane asking him to pay $868 for ‘anesthesia service.’ Bills continued trickling in, one for $76, another for $127, according to records Valeary provided. The service behind each charge was unclear, but the date was not: December 27, 2016, the day of his colonoscopy.

“‘I thought, “‘You gotta be kidding me,”” Valeary said recently. ‘You buy insurance thinking you won’t get stuck with a giant bill. If I’d known what it would cost, I wouldn’t even have done it.’

“In the end, Valeary owed close to $2,500 out-of-pocket for what he thought was a routine, preventive colonoscopy – a procedure that, under federal law, is supposed to cost the patient nothing. Unbeknownst to him and thousands of patients across the country, the cost of a colonoscopy can depend on a host of factors, including lab fees, how long the exam lasted, even what type of anesthesia was used.”  For more, click over to where Jed Lipinski writes about the topic at our partner, NOLA.com I The Times-Picayune in New Orleans, part of our “Cracking the Code” partnership.

Our partner Lee Zurik at WVUE FOX 8 Live in New Orleans did his version of this story here.

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Jeanne Pinder

Jeanne Pinder  is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded...