health insurance

Let's talk 💩

A brief look at the costs of a traditional colonoscopy vs. Cologuard, an at-home colon cancer screening kit, and how these options can impact employers.

We all know someone who has just turned 50 and is dreading knowing that their doctor will be recommending they get a colonoscopy as part of their age-based preventative cancer screenings. We've also all heard the horror stories of folks prepping for their first, or even second, colonoscopy. Having recently received a biennial colonoscopy as a part of my Ulcerative Colitis care plan, I got to thinking, "How much does all of this colonoscopy business cost anyway?"

Lucky for you, I come with receipts!

I received my colonoscopy at Midatlantic Gastrointestinal Center on 1/19/2023. MidAtlantic Gastrointestinal Center is located in Lancaster at Lancaster General Health's Harrisburg Pike campus. My endocrinologist was my normal specialist, Dr. John Betteridge, and the surgical pathologist was Dr. Jerrrey Baliff.

Here are the charges made to Highmark Blue Sheild:

Surgical Care: $1,200.00 Provider Charge / $1,200.00 Plan Paid to Provider.
Endoscopic Procedure: $870.00 Provider Charge / $349.36 Plan Paid to Provider
Surgical Pathology Test: $900.00 Provider Charge / $418.65 Plan Paid to Provider
Total: $1968.01


All of these charges and amounts got me thinking, how much does Cologuard cost? For those who haven't seen the commercials, Cologuard is a noninvasive colon cancer screening test for people 45 years of age and older who are at average risk for colon cancer. Cologuard is similar to colonoscopies in that most/all people 45 years of age and older who get colonoscopies are doing so for their once-a-decade colon cancer screening. Fortunately for us, there's an easy way to figure out the price of Cologuard w/o insurance. According to GoodRx, the cash price for a Cologuard test is ~ $600.

Wow, that's a pretty astonishing difference; the cost of a colonoscopy is $1368.01 more than the cost of Cologuard. But, is Cologuard a suitable alternative to colonoscopies? What is each method's accuracy in detecting cancer?

According to North Shore Gastroenterology, "Research indicates that colonoscopies—regardless of whether they are performed in the hospital or at an outpatient facility—yield up to 94 percent accuracy rate." According to the FAQ section of Cologuard's website, in a clinical study of 10,000 participants ages 50-84 years old, of average risk for colorectal cancer, Cologuard found 92% of cancer. 

Wow, remarkably similar results! Now, in full disclosure, I have never taken a Cologuard screening test, but I've had the chance to talk with a few people who have. From what I can tell, Cologuard, as with a colonoscopy, comes with a unique set of trades off and pros and cons. 

For employers and insurers I think this brings up an interesting and valuable question to explore further: can employers and insurers save money and continue to provide the same level of care to employees by incentivizing the use of Cologuard as a suitable alternative to colonoscopies?

If you’d like to learn more about what we are doing check out our website and follow our LinkedIn page for updates! 🐶 🚀

Similar posts

Get notified on new posts and insights

Be the first to know about new insights to manage your healthcare costs, and the latest products and trends in the industry.