U.S. hospitals charge higher facility fees for colonoscopy procedures covered by private health insurance compared to ambulatory surgical centers (ASCs), as per a study led by researchers at the Johns Hopkins Bloomberg School of Public Health.
Colonoscopies are commonly used to screen for cancer in middle-aged and older individuals, as well as those with a family history of colorectal cancer. Current guidelines suggest starting colonoscopies at age 50. These procedures are typically done at hospitals and ambulatory surgical centers.
As of July 2022, insurers are required to disclose their in-network rates for covered services. An analysis using this data revealed that hospitals billed higher facility fees for colonoscopies compared to ASCs. For instance, hospitals charged an average of $1,530 for colonoscopies, while ambulatory surgical centers charged $989. The disparity was even more significant for colonoscopies with biopsy and removal of polyps.
The study found that the facility fees for colonoscopies were 54-61 percent higher at hospitals compared to ambulatory surgical centers within the same county and under the same insurer. It’s important to note that this analysis did not include facility fees under Medicaid and Medicare insurance.