What Factors Affect the Total Cost of Your Endoscopy?

The term “endoscopy” is a broad category that refers to using a camera to look inside the body, but the specific type of procedure significantly impacts the price. An upper GI endoscopy (EGD) involves examining the esophagus, stomach, and duodenum. A “lower” endoscopy usually refers to a colonoscopy or sigmoidoscopy, which examines the large intestine.

Generally, an upper endoscopy is slightly less expensive than a colonoscopy. This is because a colonoscopy typically requires a longer procedure time, more extensive sedation, and a more complex bowel preparation process beforehand. However, if both procedures are performed during the same session—often called a “Double Scope”—the total cost is higher than a single procedure, but usually lower than if you had scheduled them on two separate days, as you only pay for the facility and anesthesia once.

Medical billing can sometimes feel like it has “hidden” layers, but these are usually standard clinical components that are billed separately. When requesting an estimate from Phoenix Unified Surgeons or any provider, be sure to ask if the quote includes:

• Pathology Fees: If Dr. Antonino Cammarata, D.O. identifies an abnormality and takes a biopsy, those tissue samples are sent to a lab. The pathologist who reviews the slides will send a separate bill.
• Anesthesia Professional Fees: The person administering your sedation (anesthesiologist or CRNA) often bills independently from the gastroenterologist.
• Facility vs. Professional Fees: Ensure your estimate includes both the doctor’s time and the “rent” for the procedure room and equipment.
• Prep Kits: For lower endoscopies, the prescription bowel prep kit is an out-of-pocket cost paid to your pharmacy.

The distinction between “screening” and “diagnostic” is one of the most important factors in determining your final out-of-pocket cost.

• Screening: Under the Affordable Care Act, many preventive screenings (like a routine colonoscopy for those over 45) are covered at 100% by insurance, meaning $0 cost to the patient. However, most upper endoscopies are not considered “screening” by insurance standards.

• Diagnostic: If you are having an endoscopy because you have symptoms—such as persistent reflux, pain, or difficulty swallowing—the procedure is “diagnostic.” Diagnostic procedures are subject to your insurance plan’s deductible and co-insurance. Even a screening colonoscopy can “turn” diagnostic if a polyp is found and removed, which may change how the insurance company processes the claim.

At Phoenix Unified Surgeons, we understand that medical expenses can be unexpected. We offer various pathways to make care affordable. Many patients utilize Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA), which allow you to pay for the procedure using pre-tax dollars.

Furthermore, we can discuss internal payment plans that allow you to break the total cost into manageable monthly installments. Third-party healthcare financing (such as CareCredit) is also a popular option, often offering 0% interest periods for medical procedures. We encourage patients to speak with our billing department early in the process to create a plan that aligns with their budget.

Dr. Antonino Cammarata, D.O. is a dedicated gastroenterologist at Phoenix Unified Surgeons who specializes in the prevention, diagnosis, and treatment of digestive tract disorders. With a focus on minimally invasive endoscopic techniques, Dr. Cammarata provides expert care for conditions ranging from GERD and Celiac disease to colon cancer screening. He is committed to a “whole-patient” approach, ensuring that every individual understands their treatment plan and the associated costs. By utilizing state-of-the-art technology in an efficient clinic setting, Dr. Cammarata helps patients achieve the best possible health outcomes while navigating the complexities of modern healthcare billing.

When estimating your costs, Dr. Antonino Cammarata, D.O. suggests keeping these three variables in mind:

• The Complexity of the Findings: While we can estimate a baseline price, the final cost may adjust if therapeutic interventions are required during the procedure, such as stopping a bleed or removing a growth.
• In-Network vs. Out-of-Network: Costs are significantly lower when you choose a provider and facility that are in-network with your insurance. Phoenix Unified Surgeons works with a wide range of providers to keep your costs down.
• The Choice of Facility: Choosing an outpatient center rather than a major hospital system can often save a patient thousands of dollars in facility fees without compromising the quality of care.

Managing your digestive health is a vital investment in your long-term well-being. While the financial aspect of medical procedures can be daunting, our team is here to provide the clarity and support you need to make the best decision for your health.

Visit Phoenix Unified Surgeons for all-encompassing gastroenterology services, where expert care is paired with transparent, patient-centered pricing. Please contact us or book your appointment online. Our office is conveniently located at 20333 N 19th Avenue, Ste 230 Phoenix, AZ 85027. We serve patients from Phoenix AZ, Sun City AZ, Peoria AZ, Surprise AZ, Glendale AZ, Scottsdale AZ, and surrounding areas.