Colonoscopy fees higher for hospitals than ASCs, study finds

Editor’s Note

US hospitals charge approximately 55% higher average fees than ambulatory surgical centers (ASCs) for colonoscopies covered by private health insurance. The findings, from the Johns Hopkins Bloomberg School of Public Health, appeared as a research letter in JAMA Health Forum on December 15.

The analysis is one of the first to use data required for the federal rule Transparency in Coverage, which requires insurers to publish in-network rates for covered items and services. Researchers used data from 13,287 colonoscopy facility fees charged by 3,582 hospitals and 17,052 ASCs across the country, as of May 2023. Fees were disclosed by four major private health insurers: Cigna, Anthem, Healthcare Service Corp, and UnitedHealthcare.

Fee comparisons focused on the hospitals and ASCs within the same county and disclosed by the same insurer. Some findings include:

• The average hospital bill for facility fees for colonoscopies was $1,530.
• For colonoscopies with biopsy, hospital facility fees were $1,760, and $1,761 for colonoscopies with removal of polyps.
• The same fees at ASCs were: $989, $1,034, and $1,030 respectively—or between 54% and 61% lower. 

The study notes that patients would benefit from payment policies that set uniform rates for standard services such as colonoscopies.