Recent regulations require hospitals and health plans to publish prices of a subset of services. The hospital rule requires publication of “shoppable services,” those that can be scheduled in advance by a consumer. The Transparency in Coverage rule requires a list of 500 items and services to be published. Colonoscopy/Removal of Polyps or Growths of Large Bowel Using an Endoscope appears on both lists, and there is a standard service package available for it. It is one of the 11 shoppable services cross-mapped from SSP with TIC + Hospital Requirement. Moreover, this is a very common procedure performed millions of times per year in the United States.
Screening tests play a key role in detecting polyps before they become cancerous. These tests can also help find colorectal cancer in its early stages, when you have a good chance of recovery. If polyps are found, your doctor may remove them immediately or take tissue samples (biopsies) for analysis. Your doctor is likely to remove all polyps discovered during a bowel examination. This service package reflects the colonoscopy procedure with polyp removal.
Colonoscopies with growth removal may be performed using multiple techniques, which may each carry a different cost. This service package bundles the more common approach, snare technique. More complex cases may carry additional associated costs; this package includes optional fees if additional growth removal is required. Your service utilization may vary for a number of reasons, including your unique clinical profile and where you receive your services.
This Service Package was generated using historical data from outpatient claims. However, this service package may also be performed in other settings. Please confirm with your provider in which care setting you will receive services, as this may affect your cost.
- Inpatient: Discuss with your provider
- Outpatient facility: 50%
- Free standing ASC: 50%
- Office: Discuss with your provider