| |
|
 |  | With Health Insurance: Copay + 10%-50% of Procedure Cost |  | Without Health Insurance: $1,500-$10,000+ |
|
Upper gastrointestinal endoscopy (also known as gastroscopy, or as EGD, which is short for esophagogastroduodenoscopy) involves the use of a flexible tube with an attached camera and light to examine the inside of the upper digestive tract, often to further investigate pain or digestive problems. (A lower GI endoscopy, more commonly known as a colonoscopy, examines the lower GI tract.) Complications are rare, but risks include reaction to the sedative, excessive bleeding and perforation of the esophagus or stomach.
Typical costs: | - For patients covered by health insurance, out-of-pocket costs typically include an office visit copay and coinsurance of 10% to 50% for the procedure. Depending on the insurance, the cost could reach $1,000 or more. For example, at Darmouth-Hitchcock Medical Center[1] in New Hampshire, a patient with Medicare would pay $1,447 without supplemental insurance. Gastrointestinal endoscopy typically is covered by health insurance when considered medically necessary. For example, Aetna[2] considers it medically necessary for diagnosis in a variety of situations, including for evaluation of certain upper abdominal symptoms, of persistent unexplained vomiting, of GI bleeding, and to investigate masses.
- For patients not covered by health insurance, upper gastrointestinal endoscopy typically costs between about $1,500-$10,000 or more, depending on the provider, geographic location, whether sedation is used or not and whether the procedure is done in an imaging center or in a hospital. The national average cost is $2,700 -- but prices can range from $1,350 to $10,400, according to NewChoiceHealth.com[3] . At the Dartmouth-Hitchcock Medical Center[4] in New Hampshire, a patient without insurance coverage would pay $3,396. At Baptist Memorial Health Care in Memphis, the cost would be about $3,512.
Related articles: Biopsy, Colonoscopy, Virtual Colonoscopy
| |
What should be included: | - In an upper gastrointestinal endoscopy, which is typically performed on an outpatient basis, the patient will be given an anesthetic for the throat and sedated using an IV. Then, the doctor will push the endoscope down the throat and into the esophagus and stomach. The images of the inside of the upper GI tract will be displayed on a large screen during the procedure, and the doctor can take a tissue sample for biopsy or remove a polyp, if necessary, during the half-hour procedure.
- The patient can go home after sedation wears off, in about an hour, but should take the rest of the day off work. No driving is permitted for up to 24 hours.
- The National Institutes of Health has an overview[5] of upper gastrointestinal endoscopy.
Additional costs: | - If it is necessary to take a biopsy, that would add a procedure cost and laboratory cost to the final bill. This could add as much as several thousand dollars to the cost. For example, at Good Samaritan Hospital in California, a biopsy adds $1,100-$4,800.
Discounts: | - Some free or low-cost clinics, such as the NYC Free Clinic[6] and the Clinic at Brackenridge[7] in Austin, TX, offer access to specialist care. The U.S. Department of Health & Human Services has a tool[8] to find a federally funded health clinic. If a nearby clinic does not offer the procedure, they can provide a referral.
Shopping for an egd: | - A physician with extensive training and experience performing gastrointestinal endoscopy should conduct the procedure. The American Society for Gastrointestinal Endoscopy offers a doctor locator[9] .
- The ASGE also offers a list of 10 questions [10] to ask any provider.
|
Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
|
|
|
|
CostHelper News
| 
7 Lesser-Known Discounts for the 50+ Crowd
As they age, members of the Baby Boomer generation don't like to admit that they're senior citizens, but they love getting discounts. It's kind of a quandary, because some of the best deals available are reduced prices for older folks. || Posted October 21 2013
| | 
7 Ways to Stretch Your Reduced Food Budget
End of the year budgets are tight for everyone, especially in this economy.It's especially hard for the millions of Americans who depend on government programs like food stamps to help make ends meet. || Posted November 11 2013
|
|
|
|
|
|
What People Are Paying - Recent Comments |
| Posted by: a user in Mandeville, LA. | Posted: March 18th, 2022 06:03PM |
| Medical Center: 852.34 | Physician: 383.86 |
Plus anesthesia doctor etc |
|
|
| Posted by: ShockedwithBill in Southfield, MI. | Posted: September 10th, 2021 10:09AM |
| Medical Center: DMC Southfield | Physician: |
I was about to cancel the appointment as not getting proper estimates for this service but day before the service got call and offered a discounted one time cost of 650 dollars + physician and Anesthesia fee which would be another 600 dollars so thought total 1200 is reasonable and went with the appointment and after 1 week of service got a Bill for 13,000 dollars with multiple different charges, looks everything charged 10 times than normal costs, after calling multiple times and arguing they said I need to pay 25% of amount to get 75% discount which I doubted as its a trick to get first 25% and they do same again to get remaining amount, so I added my Insurance details and with Insurance, it came down to 6000 dollars but I still feel its too high, not reasonable, Iam looking for alternate options how to fight this bill via lawer/legally, I Hope this post would be helpful for atleast one person, Please don't get this EGD procedure done until you have written estimated costs. |
|
|
| Posted by: Amabelle Kuhr in Torrance, CA. | Posted: September 8th, 2020 07:09PM |
| Medical Center: Prime Surgical Center of Torrance CA | Physician: Kim David O MD |
I can’t believe my bill is so much I will look for a lawyer to help me with this ridiculous bill. My insurance doesn’t pay I spent only one hour in this facility, The day of my procedure I payed 900,00 and get my bill today 14,800.00 now I can get a stomach cancer from the stress I hate Everything. |
|
|
| Posted by: jennyct in Farmington, CT. | Posted: October 26th, 2018 09:10AM |
| Medical Center: UCONN John Dempsey | Physician: REZAIZADEH |
Retail price billed to insurance for upper endoscopy whole package. I have 7300 out of pocket max. I don't think it's the insurance companies that rip you off. this procedure took about 1.5 hours and a team of 7 including pathologist. Nurses, anethesiologist, nurse anesthetist, etc. |
|
|
| Posted by: Jacob Windham in Woodlands, TX. | Posted: August 2nd, 2017 09:08PM |
| Medical Center: woodlands speciality hospital | Physician: Ifran waliwalda |
I had this procedure done in 2015 of may. and got the bill on june 7th 2015... on my birthday... for the low, low price of only 36 thousand dollars. and only just getting my primary insurance statement for it. I didnt end up having the procedure done but took care of the issue myself. ie morbidity obese. this is the reason why I dont go to hospitals or doctor's or any other place which can justify billing someone that much for 30 minutes of their time. |
|
|
| Posted by: vik in tempe, AZ. | Posted: June 28th, 2017 01:06PM |
| Medical Center: East Valley Surgery Center, LLC | Physician: Dr Debarros |
since this is out of network, I get to pay a hefty price. my out of pocket is $3,000 and still haven't done the main surgery yet... I'm gonna die |
|
|
| Posted by: US Healthcare sucks in Chciago, IL. | Posted: March 27th, 2017 11:03AM |
| Medical Center: Northwestern Medicine Chicago | Physician: |
When we went in for the procedure, we were told it would cost us ~1400 and then received a bill for ~2800 after insurance. Feel totally deceived by the healthcare system and worse part 3 months later, received another bill for $500 and when I reached out to the hospital, they said there is small asterisk at the bottom which said there might be extra costs. But never imagined extra costs would be this high. Feel totally deceived. Lost my years worth of savings. |
|
|
| Posted by: Bebe in Salem, VA. | Posted: March 2nd, 2017 11:03AM |
| Medical Center: Lewis Gale Salem Va | Physician: |
Could not believe the hospital charged 24,000 for the room for 15 minutes! For a EGD....Doctor was 3,0000. Plus other charges not yet came in....Even with this insurance I still be 5,000 to 10,000 out of pocket... Going to have to find somewhere else cheaper, should not cost that much. |
|
|
| Posted by: Disgusted by United Healthcare in Garden City, NY. | Posted: January 26th, 2017 01:01AM |
| Medical Center: New York | Physician: Nuzzo/Bsd Anesthesia |
For 18 units of anesthesia this provider first charged $6300 of which $1455 was considered allowable by United Healthcare. After having been paid by insurance and months later this provider resubmitted the claim for $6090 with the same claim codes and yet they ended up paid IN FULL. They waited just long enough for my PCA account to have a balance (January, 2017) and took nearly $1,900 of the $2,400 in my account for a procedure done in March of 2016 and I am unclear as to the legality of that. I'm still trying to get an explanation of how this was permitted because, to me, it seems like they just play with numbers until they hit it just right. Trying to get a United Healthcare supervisor (Brian M. in California) to call you back is one of the more disappointing and frustrating aspects. They know there's not a thing you can do so they just ignore you. No wonder this nation's health care is such a mess. Shame on these providers and even more so on the insurance companies. |
|
|
| Posted by: Syed Kamal in Houston, TX. | Posted: November 30th, 2016 08:11PM |
| Medical Center: Pearland Surgical Center | Physician: Not Available |
As self pay this was my bill for wife's EGD for endoscopy. Typically what would insurance companies pay for this service. This amount is $300 more than the GI specialists fee for the procedure. Suggestions / comments please. |
|
|
| Posted by: Seasonal Worker in Alaska in Juneau, AK. | Posted: September 21st, 2016 06:09PM |
| Medical Center: Alaska | Physician: undisclosed |
I worked aboard a small cruise ship in Alaska for the summer when I had a sudden urgent medical problem that necessitated both a colonospy and and endeoscopy. I didn't have insurance but I had to see a doctor. Apparently in Alaska there is a thing called the Jones Act that covers you if you work aboard a vessel. I have not received a bill for my pricy procedures. If I was going to have a problem, how lucky was it to occur while under this unique bubble of coverage. It is incredibly scary to have a medical emergency and not have any medical insurance. Something really has to give in this country. I was working a seasonal minimum wage job in Alaska, nothing glamourous. If not for that Jones Act coverage, I'd probably be in the hole at least 20 grand. |
|
|
| Posted by: Feeling screwed by Healthcare in Seattle, WA. | Posted: September 2nd, 2016 10:09AM |
| Medical Center: Swedish | Physician: |
Hospital charged me $4,144.00 for a 10 min procedure. Anesthesia was $40/min for monitoring $1600 total. The EGD equipment was $1631 for 10 min. $779 for CO2 monitoring. And two meds. My insurance paid $900 and my 20% was $667. And the gave me a 5% discount for paying in full, total was $630. No discount if you work at another hospital. Plus, paid $75 for the Dr, $104 for Anesthiologist, $140 for the sample diagnostics. All for a child who could swallow without getting food stuck in his throat. Swedish is definitely for Profit!!! |
|
|
| Posted by: JoshH in SAN ANTONIO, TX. | Posted: July 13th, 2016 07:07PM |
| Medical Center: Christian Santa Rosa | Physician: |
|
|
| Posted by: Junye Comeau in Alpharetta, GA. | Posted: July 7th, 2016 07:07AM |
| Medical Center: Atlanta Gastroenterology Specialists | Physician: Dr. Pore |
$2,467.00 for anesthesia, $1200 for EDG facility, $600 for performing doctor, $594 for Biopsy Doctor, $1416 for biopsy facility.
And the anesthersia doctor is out of network, i don't even know that she is a separate bill. all she did is to inject a sleeping liquid to the IV nurse put in.
what a joke. we have insurance, but after insurance cost, it is $3000 sqaure out of pocket. |
|
|
| Posted by: Cindy S. in Agoura HIlls, CA. | Posted: June 16th, 2016 03:06PM |
| Medical Center: West Hills Hospital, California | Physician: Dr. Sergey Belikov, MD |
We are being charged $1,893.89 for anesthesia during a routine colonoscopy. I am trying to research what is a reasonable charge for a 20 minute routine procedure? |
|
|
| Posted by: krg0423 in Andover, MA. | Posted: May 13th, 2016 10:05AM |
| Medical Center: Digestive Health Associates | Physician: Drs. Marcal, Fefferman, etc. |
I was due for an endoscopy because I have a family history of cancer of the esophagus. I have a high-deductible insurance plan with Aetna so I called them a few days before the scheduled procedure to see what my cost might be (my deductible is $3000 annually and I'm about 1/2 way towards meeting it, though I have some claims pending). I was told by the Aetna representative that the provider I had chosen, Digestive Health Associates in Woburn, MA, charges $8735 for this procedure. Aetna's "adjustment" took $7624 off this but that still left me with a balance of $1225. These prices make no sense to me. This is a 2 hour procedure. I realize it calls for general anesthesia - at least that's how my provider does it - but I'd love to see a breakdown of how we get to $8700 and change. I opted to postpone the procedure until I meet my deductible. But there's something wrong with a system that forces these choices. I'm not blaming anyone. I just want an explanation and rationalization |
|
|
| Posted by: Householdhelp60 in Fairfield, CT. | Posted: April 25th, 2016 07:04PM |
| Medical Center: Endoscopy center of Fairfield | Physician: Mauee |
I had called the office prior to my procedure and the office stated it won't cost more than $800. Facility charge $2000, pathology $1200 and doctor charge $800. I don't have funds to pay for this. Where do I go to get help? |
|
|
| Posted by: Nicholas123 in Wichita, KS. | Posted: January 9th, 2016 09:01AM |
| Medical Center: Kansas Gastroenterology | Physician: Nasser |
2500 for just scope. Nevermind all the hidden costs. Charged additional for initial consultation which lasted 5 minutes. Insurance wouldn't cover until it hits 11k. Never had procedure done knowing final results with biopsy would result in over 20k in expenses. |
|
|
| Posted by: No Thanks in Carlisle, PA. | Posted: October 9th, 2015 12:10PM |
| Medical Center: Carlisle Regional Medical Center | Physician: |
I have insurance and a 20%. They called and told me I'd be paying close $3,000 JUST FOR THE HOSPITAL. I told them no thanks and they magically lowered the price to as $980 out of pocket (estimated). That is just for the hospital keep in mind. I'd also get billed from Anesthesia for $665 for a HALF hour. This doesn't include any Biospy that may need done. May? of course it will.
This will take 1/2 hour to do. Unbelievable. |
|
|
| Posted by: mote in Englewood, NJ. | Posted: May 14th, 2015 01:05PM |
| Medical Center: Englewood hospital | Physician: dr. |
This is a perfect example how the medical facilities are simply legalized criminal robbery! We are the victims of theives everytime we see a doctor or hospital. paying twice the national ave. is not acceptable by any means. |
|
|
| Posted by: MADWIFE in Hackensack, NJ. | Posted: March 28th, 2015 08:03PM |
| Medical Center: Hackensack University Medical Center | Physician: |
This dr is out of our network, but our insurance company reimbursed her at the in-network rate. She balance-billed us for more than $6000 more. She is not the main doctor who performed this procedure - she merely assisted. I can't believe she alone can get away with gouging us like this, and I don't know where to go for help. It's disgusting. |
|
|
| Posted by: CaliforniaE in Salinas, CA. | Posted: August 25th, 2014 09:08AM |
| Medical Center: Los Palos Ambulatory Endoscopy Center | Physician: Chandra |
My copay of $148 was 20% of the insurance company allowed amount of $740. I don't know what their billed amount was yet (no EOB), but the contracted amount seems reasonable. |
|
|
| Posted by: a user in Hollywood, FL. | Posted: June 25th, 2014 03:06PM |
| Medical Center: Memorial Hospital Outpatient | Physician: |
Was quoted $250 for physician fee and over $4,000 for facility charge at outpatient facility of a hospital with insurance!! Normally we pay $250 for ER visit, $100 for mri or cat scan, etc. I never had procedure done, way too much money. I never even got to the other fee for the anathesioligist, can you imange!!! What a rip off!! |
|
|
| Posted by: MADMOM in Gibson City, IL. | Posted: February 22nd, 2013 03:02PM |
| Medical Center: Gibson Area Hospital, IL | Physician: Chung |
I couldn't believe the charge for a procedure that took less than an hour. So, I requested an itemized statement. We were charged for 2 hours in the operating room for my son's EGD. He probably was in there a half hour. The physician's charge was fair. After the insurance contract adjustment, we paid him $314. We were charged $1729 for anesthesia, $3785 for the OR, $955 for the recovery room. What a joke. Our fee is three times the national average and the cost of living here is not high. |
|
|
|
|
|
|
External Resources: | - patients.dartmouth-hitchcock.org/billing_questions/charges_for_healthcare_services...
- www.aetna.com/cpb/medical/data/700_799/0738.html
- www.newchoicehealth.com/Directory/Procedure/126/Upper%20GI%20Endoscopy
- patients.dartmouth-hitchcock.org/billing_questions/charges_for_healthcare_services...
- digestive.niddk.nih.gov/ddiseases/pubs/upperendoscopy/
- nycfreeclinic.med.nyu.edu/information-for-patients/schedule-appointment
- www.seton.net/locations/brackenridge/services
- bphc.hrsa.gov/technicalassistance/taresources/slidingscale.html
- www.asge.org/Apps/FindADoctor/search.aspx
- www.asge.org/patients/patients.aspx?id=370
More Health & Personal Care Topics
|
Search Thousands of Topics on CostHelper.com
|
|
| |
| Today's Featured Cost Articles |
|
|
|
|
Post
