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I had an endoscopy done at a surgery center, they are charging my insurance $37,000 for the endoscopy alone. My insurance is suppose to cover 100% of the cost but I feel that they are over ...
An endoscopy falls into the category of an outpatient procedure. That means that it is usually covered under Medicare Part B, the part of Medicare devoted to outpatient medical treatments and diagnostic procedures. If your doctor determines that the procedure is medically necessary, Medicare Part B may help cover the costs.
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.
Typical cost of Endoscopy: If you are not covered by the health insurance, you need to pay an expensive price for the procedure. The average cost can reach $1,500 to $10,000 as it depends on the geographic location, provider, whether sedation/anesthesia is used or not, whether the procedure is performed in an imaging center or in hospital.
A gastrointestinal endoscopy may be done in a doctor's office, a clinic, or a hospital. An overnight stay in the hospital usually isn't needed. The test is most often done by a doctor who specializes in problems of the digestive system ( gastroenterologist ). The doctor may also have an assistant.
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Insurance companies vary with regard to coverage for endoscopy procedures. We strongly encourage you to check your coverage by calling your insurance company directly before any procedure is performed to find out what your benefits are and if you may have any out of pocket expenses for your procedure. Every health plan is different.