The average cost of a colonoscopy in the U.S. is around $2,125, with about $80 in out-of-pocket fees. The exact amount depends on where the procedure is performed and whether you have insurance coverage. While the cost may seem high, colonoscopies play a crucial role in detecting colorectal cancer early, improving treatment outcomes, and saving lives.

What Is A Colonoscopy

A colonoscopy is a procedure in which a healthcare provider uses a lighted scope with a tiny camera to examine the rectum and colon. The test checks for abnormalities such as polyps—small tissue growths that are often harmless but can sometimes develop into cancer.

There are two main types:

  • Screening colonoscopy – performed as part of cancer prevention.

  • Diagnostic colonoscopy – performed when symptoms like abdominal pain or chronic diarrhea need investigation.

Why Colonoscopies Are Important

The American Cancer Society estimated more than 106,000 new colon cancer cases and 46,000 rectal cancer cases in 2023. Colonoscopies help detect cancer in its earliest stages, when treatment is most effective.

Experts recommend starting screenings at age 45, or earlier if you have higher risk factors.

How Insurance Covers Colonoscopies

Under the Affordable Care Act (ACA), private insurers and Medicare are required to cover colorectal cancer screening tests, including colonoscopies, with no out-of-pocket costs for people aged 45 and older.

However, coverage rules vary:

  • Some policies cover the procedure fully only if it is preventive.

  • If polyps are removed, insurers may classify the test as diagnostic, leading to additional costs such as copays.

  • Medicare beneficiaries may still face certain copays, even when the procedure is coded as screening.

Colonoscopies For People Under 45

Insurance coverage under age 45 usually requires proof of medical necessity. Factors that may justify early screening include:

  • Family history of colon cancer or polyps

  • Personal history of colon cancer, polyps, or inflammatory bowel disease

  • History of abdominal or pelvic radiation

In these cases, your doctor may need to submit a letter of medical necessity to secure approval.

Unexpected Colonoscopy Costs

Even with insurance, additional charges may arise:

  • Out-of-network providers: Anesthesiologists, pathology labs, or surgery centers not covered by your plan can bill separately.

  • Bowel prep kits: Often not fully covered.

  • Complication coding: If polyps are removed, your screening may be reclassified as diagnostic.

To reduce surprises, always confirm that every provider involved in your procedure is in-network.

Medicare And Colonoscopy Billing

Medicare rules can be complex. While the Centers for Medicare & Medicaid Services (CMS) indicates that polyp removal should be included in the screening, patients may still see charges.

Recent guidelines emphasize “intent-based coding”—meaning if the colonoscopy was scheduled as a preventive screening, it should be billed as such, regardless of findings.

Paying For A Colonoscopy Without Insurance

For uninsured patients, the cost can be overwhelming. Fortunately, there are affordable alternatives:

  • ColonoscopyAssist: Provides discounted colonoscopies in many U.S. cities.

  • Colorectal Cancer Alliance: Connects patients with low-cost colonoscopies or at-home tests.

  • New York State Cancer Services Program (CSP): Offers free colonoscopies for eligible uninsured residents.

  • Healthcare Bluebook: Helps patients compare prices in their area.

Questions To Ask Before Your Procedure

To avoid surprise bills, consider asking your insurer:

  • What out-of-pocket costs will I face?

  • Is the anesthesiologist in-network?

  • Can I save money by scheduling at an ambulatory surgery center instead of a hospital?

Final Thoughts

Colonoscopy costs can vary widely depending on your insurance status, provider, and location. While the price may be high, the potential cost of untreated colorectal cancer is far greater.

Being proactive—by asking questions, verifying in-network providers, and exploring financial assistance programs—can make this life-saving screening more affordable and accessible.