Paying for the Displeasure of a Colonoscopy

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I am an American who works in Bangkok and has California Blue Shield. Just went for a colonoscopy (June 2008) at Bumrungrad Hospital, probably the best hospital in Southeast Asia. The complete cost was 22,822 baht ($692 USD), including hospital and doctor's fees (physician was a board-certified gastro-enterologist). When I read that some states don't cover this procedure and others charge upwards of $3-5,000 USD, I feel fortunate to have access to this excellent care.

guy 8:29PM June 23, 2008

I guess I should have shopped around but I thought I did enough research on
the web to get in the ballpark but they weren't close. As some of
the others have already stated it runs anywhere from $3-7K for a colonoscopy
done in a hospital setting. The facility fee was the highest claim coming in
at $4200 and the dr was $1000. That was knocked down to around $2800
after the insurance adjustment. Unfortunately I have a history of polyps and
already waited to long so I needed to get things checked out due to symptoms I
was having .Luckily I guess I have nothing wrong but it cost me alot of money
for the piece of mind.

Jeff of CA 1:28AM June 14, 2008

Cannot afford colonoscopy. I have good retirement coverage with Premara-Alaska, but it does not cover screening colonoscopies. Deplorable state.

st of AK 3:02PM May 15, 2008

yeah we bill out 1200 per colon but m/c or bcbs ...only allow about $350.00 for the doctor....anesthesia is the next cost and they are often not covered separately by insurances and then the facility costs...they charge as much or than the physician and receive allowables more than the physicians...other costs are about pathology and or labs as per individual.....so billed costs are abot 1100-3000 but returns are about 700-1500 total for the procedure...no one is getting rich...often the procedures are contested by the insurances and often patients are stuck with high deductables adn more out of pocket expences...as for the prep...not as bad as it used to be...clear liquids and we use osmo prep ....pills to clean out...high compliance and encourages sufficient fluid intake to help avoid reactios to the prep...doesnt taste bad either...

snowy of IL 3:09PM April 25, 2008

No, Michigan has no legislation requiring insurance coverage of colorectal cancer screening. That does not mean your insurance does not cover the screening, but there is no mandate to do so. They can change their minds at any time. They can refuse to cover the more effective colonoscopy screening.
For information on what states cover screening -- and how effectively go to:
http://www.eifoundation.org/national/nccra/report_card/
For broad federal coverage of colorectal screening for every person go to:
http://www.coveryourbutt.org

Kate Murphy of NY 10:00AM March 21, 2008

I am wondering if Michigan has coverage for colon screening?
Thank you.

Jacqueline West of MI 10:19AM March 19, 2008

I don't know where you get your cost figures from ("$800 to $1,600 per"). And by the way, the procedure these days is not onerous at all--you're put totally to sleep. (The day-before preparation is sort of onerous.)
I live in a medium-cost area, and I have Blue Shield. The total billing amount for my routine screening procedure, a couple of months ago, was more than $5000. It seems like half the health-care professionals in the area got involved. My inner cynic suspects it's turned into a giant spigot of profit for everybody. Blue Shield disallows a portion of the billing, which then becomes a tax write-off for the providers involved. That's a blatant spurious accounting game. And, in the end, Blue Shield and I still paid out close to $3000.
There are clear theoretical benefits to routine colonoscopy screening, both to the individual and to a healthcare system that underspends on prevention. It should be a prime example of the ounce of prevention that can prevent the pound of cure. So there's real incentive for everybody to get screened--until you come to the actual cost.
Screening procedures with clear preventive benefits should not become a golden pig trough for the health care industry. At the price I was billed, few people without top-line health insurance will even consider the procedure. Any health-care 'reform' proposals worthy of the name must address these kinds of issues.

John D of OR 9:01PM March 17, 2008

I loved your article. I won't be able to tell you everything because I have a broken wrist. I will be glad to mail my story to you. Our problem was not the laws but the HMO's. I almost died of colon cancer because my HMO paid my primary care doctor to not recommend his patient's to specialists. I have this in writing. I would love to mail this to you if you would give me permission. I am now a fervent colon cancer patient advocate.

Ms. Frankie Ann Goodson of AR 3:46PM March 17, 2008

> Given my aversion, which many others share, states would be smart to make getting the test as easy and affordable as possible.
This makes no sense at all. People don't avoid colonoscopies because of state law, they avoid them because of the prep.

Jane of AL 11:00AM March 17, 2008

I'm a lucky one in the fact that I found out that I have the pre-cancer cells that could turn into colon cancer. My mom died when she was 40 and my brother was diagnosed with it in late 2006. I think a lot has to also do with the fact that people don't want to know if they're sick. Most places if you can't afford to pay for it will either do a payment arrangement or if you pay out of your pocket, will cut you a deal.
If your life is important to you, you find a way to get things done. If not then you find out too late you are the one to blame because there are ways and options to pay for things.

Ticked off of CA 6:24PM March 14, 2008