Price reports for 44392 Colonoscopy & polypectomy

Community member

Price charged

$20.00

Insurance paid

$0.00

You paid

$20.00

Insurer: Kaiser Permanente
Provider: Kaiser Permanente Medical Center
Address: Los Angeles, 6041, Cadillac Avenue, CA
PriceCheck journalist

Price charged

$117.42

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.smmcnj.com/for-patients-visitors/financial-assistance/ .
Provider: St. Michael's Medical Center
Address: Newark, 111 Central Ave., NJ
Community member

Price charged

$973.00

Insurance paid

$340.89

You paid

$45.00

I was charged a $45 co-pay for the initial visit, but nothing for the actual procedure.
Insurer: Blue Cross Blue Shield of Florida (Florida Blue)
Provider: Sarasota Memorial Hospital
Address: Sarasota, 1700, South Tamiami Trail, FL
Community member

Price charged

$1,063.00

Insurance paid

$722.13

You paid

$340.87

I paid $340.87 for the doctor. Then I received an other bill for $75.46. The Galloway BAPTIST center charged $800. The doctors charged $590, anesthesiology $300Total $1063.09
Provider: Flavia Mendes, M.D.
Address: Miami, 7500, Southwest 87th Avenue, FL
PriceCheck journalist

Price charged

$1,181.84

Insurance paid

$0.00

You paid

$0.00

Price from pricing page https://www.wphospital.org/patients-visitors/patients/billing-information/standard-charges/.
Provider: White Plains Hospital
Address: White Plains, 41 E. Post Rd., NY
Community member

Price charged

$1,210.00

Insurance paid

$341.44

You paid

$85.36

I did not have anesthesia. The doctor insisted that they place an IV in my arm in case of emergency, but it was not used.
Provider: Springfield Ambulatory Surgery Center
Address: Glenside, 1528, Bethlehem Pike, PA
Community member

Price charged

$2,040.00

Insurance paid

$2,040.00

You paid

$0.00

As good an experience as a colonoscopy can be! Dr. Slezak conducts procedures in her own out-patient facility, which is staffed by compassionate nurses and other attendants. Dr. Slezak is patient, easy to talk to, and was recommended by both friends and my trusted ob/gyn.
Insurer: Blue Cross Blue Shield of Florida (Florida Blue)
Provider: Dr. Lori A. Slezak, MD
Address: Tampa, 4814, North Habana Avenue, FL
Community member

Price charged

$2,289.00

Insurance paid

$0.00

You paid

$2,289.00

This bill does not include hospital, pathology, or anesthesia fees. We are still awaiting those charges. My husband is self-employed, so we have to bear the cost of non-group health insurance coverage. Our monthly premium is over $1700 and our family, in-network deductible is $13,400 per year and $60,300 out-of-network.
Insurer: Anthem Blue Cross Blue Shield
Provider: Fackler William K MD
Address: Macon, 1014, Forsyth Street, GA
Community member

Price charged

$2,600.00

Insurance paid

$1,000.00

You paid

$1,622.50

Don't recall total price of procedure but my out of pocket for my 1st colonoscopy was 1622.50. I tried to negotiate my cost and was denied because I am single and make 15 dollars an hour and according to them should be able to pay in full and on time. The balance is still unpaid.
Provider: Upstate Medical University
Address: Syracuse, 750, East Adams Street, NY
Community member

Price charged

$2,730.00

Insurance paid

$382.00

You paid

$150.00

Insurer: Anthem Blue Cross Blue Shield
Provider: Dr. Saeed Ahmed, MD
Address: Elizabethtown, 1107, Woodland Drive, KY
PriceCheck journalist

Price charged

$3,710.78

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.nyp.org/patients-visitors/paying-for-care/hospital-price-transparency .
Provider: NYP Hudson Hospital
Address: Cortlandt Manor, 1980 Crompond Rd., NY
Community member

Price charged

$3,740.00

Insurance paid

$972.17

You paid

$0.00

Insurer: Medicare
Provider: The Endoscopy and Surgery Center of Topeka
Address: Topeka, 2200, Southwest 6th Avenue, KS
Community member

Price charged

$4,300.00

Insurance paid

$2,658.00

You paid

$0.00

Insurer: Blue Cross Blue Shield of Florida (Florida Blue)
Provider: Gastro Health, LLC
Address: Miami, 7500, Southwest 87th Avenue, FL
Community member

Price charged

$4,794.00

Insurance paid

$354.07

You paid

$2,874.96

Colonoscopies are supposed to be covered under ObamaCare so we were surprised to receive such a large bill. We have since learned that screening colonoscopies are covered but not diagnostic. Once you have a polyp removed, our local clinic codes every colonoscopy thereafter as diagnostic so you no longer qualify for the required, covered one under the law. No one tells you this until AFTER you receive the bill and there is nothing you can do about it. The procedure is exactly the same. Is this just a way for the clinic to make more money? Our insurance company can't help us and the clinic refuses to change the code. How about everyone pays the same price?
Provider: Gundersen Lutheran Medical Center
Address: La Crosse, 1900, South Avenue, WI
Community member

Price charged

$5,835.92

Insurance paid

$2,547.98

You paid

$577.30

$5835.92 - total cost billed; $2949.44 - price discounted to
Insurer: UnitedHealthcare
Provider: Emerson Hospital
Address: Concord, 133, Old Road to 9 Acre Corner, MA
Community member

Price charged

$5,974.81

Insurance paid

$424.99

You paid

$2,606.25

Buy my own insurance with $2500 deductable. Member Discount Amount was $2,943.57 was deducted which I don;t know what that it. Removed 3 benign polyps. Doc said it was routine.
Insurer: Blue Cross Blue Shield of Louisiana
Provider: Ochsner Medical Center
Address: Jefferson, 1514, Jefferson Highway, LA
Community member

Price charged

$6,015.45

Insurance paid

$5,792.80

You paid

$222.65

$1294 charged for polyps & lab
Insurer: AARP
Provider: Broward Health Imperial Point
Address: Fort Lauderdale, 6401, North Federal Highway, FL
Community member

Price charged

$6,050.00

Insurance paid

$2,299.15

You paid

$839.99

Because my husband had a polyp on his colonoscopy 5 years ago, the doctor no longer codes his colonoscopy as preventative, it's now diagnostic and costs us over $800.00 instead of $0
Insurer: Cigna
Provider: Lafayette
Address: Lafayette, ,, CO
Community member

Price charged

$7,720.00

Insurance paid

$6,002.00

You paid

$1,718.00

Combined colonoscopy and endoscopy, all charges for physician and hospital.
Insurer: Anthem Blue Cross (California)
Provider: Saint John's Health Center
Address: Santa Monica, 2121, Santa Monica Boulevard, CA
Community member

Price charged

$9,000.00

Insurance paid

$0.00

You paid

$5,800.00

My family and I use a medical share plan - Samaritans Ministries, which is slightly different to insurance, but we have been very happy to use it for the last three years. When seeing doctors etc, we let them know that we do not have normal insurance and that in essence we are cash patients (see Samaritans Ministries for details about the plan and how it works) The colonoscopy was scheduled for the procedure on the Tuesday. It was recommended by my doctor because I have just turned 50. After trying to get a price at the appointment, on the Thursday of the previous week, I was told that they would let me know once I spoke to the accounting department. So paid the $200 consultation fee - did not see Doctor - saw a PA who explained the procedure and what to expect and to receive a prescription for items needed to prepare for the procedure. The following day, Friday, I received a call to find out if I qualified for medi-care. Even after explaining that I didn't qualify and that I just wanted to know what to expect to pay for procedure, it was insisted that they had to ask me a series of questions relating to current job and yearly household income. They told me that yes, I did not qualify for medi-care and that someone else would contact me with the cost of the procedure. I received a call later that day to let me know that the procedure normally costs $9000 but the discount offered across the board and for me , because I am a cash patient would bring the price down to $5800 - I nearly fell off my chair and told her that I would need to call her back once I looked into a bit more. Because this procedure it qualified as preventative and routine checkup my medical share plan will not cover it. However, the plan would cover it if it was prescribed as necessary due to a something picked up due to a routine examination. I decided to look at alternative options and promptly cancelled the colonoscopy with that medical group. My medical share plan did point me to MD SHARE which allows one to enter in a procedure and to see what other doctors will charge for the same procedure. I found a doctor about 45 miles away who would charge $2300 for the procedure. I looked up her reviews and found that she would be a perfect fit for me. I was then able to pre-purchase the procedure, which I will be taking with me to me appointment this Thursday 26th September. I will still pay for the initial consultation out of pocket but I'm okay with that. In retrospect, I'm pretty sure that the first doctors were charging the $5800 because I could afford it. I cant be sure, but I suspect it. I'm not sure why procedures would be so much more expensive in our area as apposed to another area only 45 miles away? I am happy to pay the amount as it is an average cost for that procedure. MD SAVE is a great place to be able to compare prices for procedures. The pricing also lets you know what the cost covers. Good questions to ask when I do see the Dr this Thursday, is what any costs I can expect to cover that aren't included in the invoice I have already paid? i.e. if they do find a polyp, what extra cost to remove said polyp and pathology tests for that polyp etc... Thanks for doing this segment. It is needed so much - Transparency is critical....
Provider: Mulberry Creek Road
Address: Mulberry, , Mulberry Creek Road, NC
Community member

Price charged

$9,106.00

Insurance paid

$2,437.00

You paid

$0.00

Insurer: Blue Cross Blue Shield of Florida (Florida Blue)
Provider: Cleveland Clinic Florida
Address: Weston, 2950, Cleveland Clinic Boulevard, FL
Community member

Price charged

$9,400.00

Insurance paid

$650.00

You paid

$6,102.00

I was stuck with the final bill of $6,102. My insurance policy was something that I purchased after I lost my job. I purchased it through Freedom Life. four polyps were removed. I feel robbed. Luckily, I have a new job and new insurance.
Insurer: Cigna
Provider: MUSC Health East Cooper Medical Pavilion
Address: Mount Pleasant, 1600, Midtown Avenue, SC
Community member

Price charged

$10,309.00

Insurance paid

$1,536.93

You paid

$6,724.07

I have not paid this. I am appealing with Blue Shield of California. This was a routine screening colonoscopy. Blue Shield is refusing to pay because it was done in a hospital...even though in my rural area there is no ambulatory surgery center.
Insurer: Blue Shield of California
Provider: Adventist Health Sonora
Address: Sonora, 1000, Greenley Road, CA
Community member

Price charged

$10,368.70

Insurance paid

$1,811.02

You paid

$0.00

This does not include anesthesia or the doctor who performed the procedure.
Insurer: Blue Cross Blue Shield of Florida (Florida Blue)
Provider: Sarasota Memorial Hospital
Address: Sarasota, 1700, South Tamiami Trail, FL
Community member

Price charged

$11,132.00

Insurance paid

$10,160.10

You paid

$971.87

This was my second colonoscopy in four years. They couldn't see everything they needed to see in the first one so ordered another one this year. This became a "diagnostic" colonoscopy when one polyp was removed.I was very surprised to see that a University hospital which has over a billion dollars in revenue can't make a relatively simple procedure more affordable than this. A group called Colonoscopy Assist which does this for people with no insurance does this procedure for $1075 and it includes everything. No wonder insurance rates are so high.
Insurer: Blue Cross Blue Shield of North Carolina
Provider: Wake Forest University Baptist Medical Center
Address: Winston-Salem, , Medical Center Boulevard, NC
Community member

Price charged

$12,012.30

Insurance paid

$6,592.32

You paid

$732.48

THIS WAS JUST FOR THE HOSPITAL COST/DOCTOR, PATHOLOGIST, AND ANESTHESIA WERE SEPARATE. TOTAL COST FOR COLONOSCOPY (HOSPITAL AND VARIOUS DOCTORS) WAS $16753.92. I HAD A $1500 DEDUCTIBLE, THEN CO-PAYS FOR EACH SERVICE PERFORMED.
Insurer: Blue Cross Blue Shield of North Carolina
Provider: Baptist Endoscopy Center at Coral Springs
Address: Coral Springs, 3001, Coral Hills Drive, FL
Community member

Price charged

$14,346.00

Insurance paid

$2,116.14

You paid

$1,156.80

I spoke with a CIGA representative about the HUGE discrepancies in these numbers but could not get any satisfactory answers. I have been questioning the very premise of "Health Insurance" lately. Billl Maher got me thinking about the basic idea of insurance. We get insurance for things we don't expect to happen but plan for them anyway. For example: I have car insurance not because I expect to get into an accident but just in case I do, I have hurricane insurance (Windstorm, Flood) not because I expect my hose to get destroyed in a hurricane but just in case it does. I don't know anyone who thinks they will not get sick at some time. We all get sick. So shouldn't we just have a healthcare plan to provide the care we need ? I mean, think about it, between my employer and I we probably give CIGNA over $10,000 a year just to pay my healthcare bills and I have a $3,000 deductible on top of that! I would be willing to throw $10,000 a year into a healthcare fund, keep paying my $3,000 deductible and have a basic healthcare plan that would even limit my benefits as I get older! I'm 61 now so lets say I have an upper limit on the amount of money my healthcare plan will spend trying to keep my older ass alive, something like one million dollars. I think it's stupid spending a lot of money keeping old people alive while younger people go without healthcare.
Insurer: Cigna
Provider: Carp Marc S MD
Address: North Miami Beach, 1400, Northeast Miami Gardens Drive, FL
Community member

Price charged

$15,044.00

Insurance paid

$4,425.06

You paid

$166.80

11/15/2016 they charged for: Surgery Hospital Serv Injection Injection Hospital Serv All separate charges totaling 12212.00; paid $3382. Surgeon charge $1,492, they paid $568.07, I paid nothing. Pathology charge $440, they paid nothing, I paid $166.80. Anesthesia charge $900, they paid $474.99, I paid nothing.
Insurer: Aetna
Provider: University of Pennsylvania
Address: Philadelphia, ,, PA
PriceCheck journalist

Price charged

$17,924.00

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.nyp.org/patients-visitors/paying-for-care/hospital-price-transparency .
Provider: New York-Presbyterian Weill Cornell Medical Center
Address: New York, 525 E. 68th St., NY
PriceCheck journalist

Price charged

$17,924.00

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.nyp.org/patients-visitors/paying-for-care/hospital-price-transparency .
Provider: New York-Presbyterian Weill Cornell Medical Center
Address: New York, 525 E. 68th St., NY
PriceCheck journalist

Price charged

$17,924.00

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.nyp.org/patients-visitors/paying-for-care/hospital-price-transparency .
Provider: New York-Presbyterian Weill Cornell Medical Center
Address: New York, 525 E. 68th St., NY
PriceCheck journalist

Price charged

$17,924.00

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.nyp.org/patients-visitors/paying-for-care/hospital-price-transparency .
Provider: New York-Presbyterian Weill Cornell Medical Center
Address: New York, 525 E. 68th St., NY
PriceCheck journalist

Price charged

$17,924.00

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.nyp.org/patients-visitors/paying-for-care/hospital-price-transparency .
Provider: New York-Presbyterian Weill Cornell Medical Center
Address: New York, 525 E. 68th St., NY
PriceCheck journalist

Price charged

$17,924.00

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.nyp.org/patients-visitors/paying-for-care/hospital-price-transparency .
Provider: New York-Presbyterian Weill Cornell Medical Center
Address: New York, 525 E. 68th St., NY
PriceCheck journalist

Price charged

$17,924.00

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.nyp.org/patients-visitors/paying-for-care/hospital-price-transparency .
Provider: New York-Presbyterian Weill Cornell Medical Center
Address: New York, 525 E. 68th St., NY
PriceCheck journalist

Price charged

$17,924.00

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.nyp.org/patients-visitors/paying-for-care/hospital-price-transparency .
Provider: New York Presbyterian Hospital Queens
Address: Flushing, 56-45 Main St., NY
PriceCheck journalist

Price charged

$17,924.00

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.nyp.org/patients-visitors/paying-for-care/hospital-price-transparency .
Provider: Columbia University Irving Medical Center
Address: New York, 630 W. 168th St., NY
PriceCheck journalist

Price charged

$17,924.00

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.nyp.org/patients-visitors/paying-for-care/hospital-price-transparency .
Provider: New York-Presbyterian Lower Manhattan Hospital
Address: New York, 170 William St., NY
PriceCheck journalist

Price charged

$17,924.00

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.nyp.org/patients-visitors/paying-for-care/hospital-price-transparency .
Provider: Lawrence Hospital - NYP
Address: Bronxville, 55 Palmer Ave., NY
PriceCheck journalist

Price charged

$17,924.00

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.nyp.org/patients-visitors/paying-for-care/hospital-price-transparency .
Provider: Lawrence Hospital - NYP
Address: Bronxville, 55 Palmer Ave., NY
PriceCheck journalist

Price charged

$17,924.00

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.nyp.org/patients-visitors/paying-for-care/hospital-price-transparency .
Provider: New York-Presbyterian Brooklyn Methodist Hospital
Address: Brooklyn, 506 Sixth St., NY
PriceCheck journalist

Price charged

$17,924.00

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.nyp.org/patients-visitors/paying-for-care/hospital-price-transparency .
Provider: New York-Presbyterian Brooklyn Methodist Hospital
Address: Brooklyn, 506 Sixth St., NY
PriceCheck journalist

Price charged

$17,924.00

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.nyp.org/patients-visitors/paying-for-care/hospital-price-transparency .
Provider: New York-Presbyterian Brooklyn Methodist Hospital
Address: Brooklyn, 506 Sixth St., NY
PriceCheck journalist

Price charged

$17,924.00

Insurance paid

$0.00

You paid

$0.00

From pricing page: https://www.nyp.org/patients-visitors/paying-for-care/hospital-price-transparency .
Provider: New York-Presbyterian Allen Hospital
Address: New York, 5141 Broadway, NY
Community member

Price charged

$21,991.20

Insurance paid

$21,559.20

You paid

$431.97

Colonoscopy procedure; 5 polyps removed. The care was the best! Two of the polyps removed had the potential of becoming cancerous. Follow-up colonoscopy in 5 years. Medicare paid most of this. Grateful!
Provider: Dr. Philip N. Okafor, MD
Address: Boston, 72, East Concord Street, MA
Community member

Price charged

$25,537.50

Insurance paid

$4,593.69

You paid

$20,943.80

The amount charged is totally absurd. The low amount paid by my insurance company is also crazy. The deductible for my insurance policy was already met before I had the colonoscopy. Humana explained that the procedure is "preventative" and therefore most of it is not covered. I had 18 polyps removed and have a history of colon polyps. That doesn't sound "preventative" to me. I was also penalized for using an out-of-network anesthesiologist. I had no choice regarding the anesthesiologist. I'm fighting Humana's decision, but it's a very uphill battle.
Insurer: Humana
Provider: St. Joseph's Hospital - North
Address: Lutz, 4211, Van Dyke Road, FL

What Medicare pays here?

Colonoscopy & polypectomy
Region Price
Alabama $192.64
Alaska $274.76
Arizona $204.59
Arkansas $193.21
Anaheim/Santa Ana, CA $222.40
Los Angeles, CA $216.70
Marin/Napa/Solano, CA $220.72
Oakland/Berkeley, CA $223.19
Rest of California $208.96
San Francisco, CA $231.58
San Mateo, CA $231.21
Santa Clara, CA $230.79
Ventura, CA $218.13
Colorado $211.72
Connecticut $224.55
DC + MD/VA Suburbs $233.52
Delaware $214.22
Fort Lauderdale, FL $226.58
Miami, FL $243.16
Rest of Florida $213.98
Atlanta, GA $211.34
Rest of Georgia $204.92
Hawaii/Guam $213.29
Idaho $193.79
Chicago, IL $231.55
East St. Louis, IL $221.60
Rest of Illinois $208.90
Suburban Chicago, IL $225.60
Indiana $192.16
Iowa $192.30
Kansas $196.43
Kentucky $198.61
New Orleans, LA $213.14
Rest of Louisiana $206.72
Rest of Maine $198.22
Southern Maine $203.52
Baltimore/Surr. Cntys, MD $224.55
Rest of Maryland $214.60
Metropolitan Boston $216.58
Rest of Massachusetts $217.70
Detroit, MI $223.01
Rest of Michigan $205.06
Minnesota $197.56
Mississippi $188.93
Metropolitan Kansas City, MO $208.91
Metropolitan St Louis, MO $208.26
Rest of Missouri $201.06
Montana $222.48
Nebraska $190.37
Nevada $209.23
New Hampshire $213.56
Northern NJ $224.93
Rest of New Jersey $219.22
New Mexico $209.81
Manhattan, NY $240.00
NYC Suburbs/Long I., NY $250.93
Poughkpsie/N NYC Suburbs, NY $222.46
Queens, NY $251.46
Rest of New York $198.46
North Carolina $199.29
North Dakota $200.46
Ohio $204.67
Oklahoma $202.02
Portland, OR $210.01
Rest of Oregon $203.31
Metropolitan Philadelphia, PA $224.81
Rest of Pennsylvania $206.42
Puerto Rico $209.98
Rhode Island $216.28
South Carolina $195.24
South Dakota $197.42
Tennessee $194.01
Austin, TX $205.95
Beaumont, TX $201.76
Brazoria, TX $208.86
Dallas, TX $207.46
Fort Worth, TX $204.66
Galveston, TX $209.73
Houston, TX $211.75
Rest of Texas $201.76
Utah $208.53
Vermont $202.51
Virgin Islands $209.98
Virginia $207.02
Rest of Washington $208.46
Seattle (King Cnty), WA $220.89
West Virginia $206.81
Wisconsin $193.89
Wyoming $207.33
Bakersfield, CA $209.20
Chico, CA $208.07
El Centro, CA $208.23
Fresno, CA $208.07
Hanford-Corcoran, CA $208.19
Los Angeles-Long Beach-Anaheim (Los Angeles Cnty), CA $220.46
Los Angeles-Long Beach-Anaheim (Orange Cnty), CA $220.46
Madera, CA $208.07
Merced, CA $208.07
Modesto, CA $208.07
Napa, CA $221.77
Oxnard-Thousand Oaks-Ventura, CA $217.17
Redding, CA $208.07
Riverside-San Bernardino-Ontario, CA $212.05
Sacramento--Roseville--Arden-Arcade, CA $210.08
Salinas, CA $210.51
San Diego-Carlsbad, CA $211.23
San Francisco-Oakland-Hayward (Alameda/Contra Costa Cnty), CA $227.87
San Francisco-Oakland-Hayward (Marin Cnty), CA $225.22
San Francisco-Oakland-Hayward (San Francisco Cnty), CA $227.87
San Francisco-Oakland-Hayward (San Mateo Cnty), CA $227.87
San Jose-Sunnyvale-Santa Clara (San Benito Cnty), CA $220.87
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty), CA $230.03
San Luis Obispo-Paso Robles-Arroyo Grande, CA $208.69
Santa Cruz-Watsonville, CA $214.76
Santa Maria-Santa Barbara, CA $212.83
Santa Rosa, CA $212.07
Stockton-Lodi, CA $208.07
Vallejo-Fairfield, CA $221.77
Visalia-Porterville, CA $208.07
Yuba City, CA $208.07
Rest Of California, CA $208.07
Hawaii, GUam $211.19
Metropolitan Boston, MA $226.34