U.S. hospitals' facility fees for colonoscopy procedures covered by private health insurance are on average about 55% higher than facility fees billed by ASCs, according to a study led by researchers at the Johns Hopkins Bloomberg School of Public Health in Baltimore.
The study was published in JAMA Health Forum on Dec. 15. Researchers examined Transparency in Coverage data for 13,287 colonoscopy facility fees charged by 3,582 hospitals and 17,052 ASCs in 50 states and Washington, D.C., as of May 2023, according to a Dec. 15 news release from Johns Hopkins Bloomberg School of Public Health. Insurer data came from Cigna, Anthem, Healthcare Service Corp. and UnitedHealthcare.
As of June 2022, insurers must publish their in-network rates for covered items and services under a Transparency in Coverage requirement.
The study found that hospitals billed an average of $1,530 in facility fees for colonoscopies, $1,760 for colonoscopies with biopsy, and $1,761 for colonoscopies with removal of polyps, compared to $989, $1,034, and $1,030 in facility fees, respectively, at ASCs. Respectively, colonoscopy facility fees were 54%, 56%, and 61% higher at hospitals than ASCs located in the same county and contracting with the same insurer, according to the study.
Facility fees charged under Medicaid and Medicare were not examined in this study.