The fees posted on this page are in effect on January 1, 2020. These are the direct pay prices that are charged prior to negotiated discounts (as are typically applied by a contracted insurance company or in the case of an uninsured patient, may be offered by the practice for a cash payment at the time of service).
Contact your insurance company directly (many companies provide web-based charge estimators) to determine your contracted discount and anticipated out-of-pocket liability, which is affected by your deductible and copay arrangements. In most cases, patients having screening procedures (such as screening colonoscopy), are exempt from out-of-pocket deductible and copay obligations.
|
| Service |
|
Fee |
|
| New patient office visit |
|
|
|
| level 2 (99202) |
|
$119 |
|
| level 3 (99203) |
|
$176 |
|
| level 4 (99204) |
|
$251 |
|
| level 5 (99215) |
|
$327 |
|
| Established patient office visit |
|
|
|
| level 2 (99212) |
|
$75 |
|
| level 3 (99213) |
|
$113 |
|
| level 4 (99214) |
|
$170 |
|
| level 5 (99215) |
|
$245 |
|
| Consultation |
|
|
|
| level 2 (99242) |
|
$214 |
|
| level 3 (99243) |
|
$276 |
|
| level 4 (99244) |
|
$352 |
|
| Hemorrhoid band ligation (46221) |
|
$415 |
|
| Capsule endoscopy - small bowel videocapsule endoscopy, including charge for telemetry capsule (91110) |
|
$1,992 |
|
| Bravo ambulatory esophageal pH study, including charge for telemetry capsule (91035) |
|
$1,000 |
|
|
Endoscopy Center Services
|
| Service |
Professional Service Fee
Doctor charge from Digestive Health |
Facility Fee
Charge from Southwest Endoscopy |
Anesthesia Fee
Charge from Animas Anesthesia
Anesthesia fees are time based (and may be higher than the estimate below for unusually long cases). Screening colonoscopy procedures are priced lower than diagnostic/therapeutic colonoscopy procedures. |
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| Colonoscopy (45378) |
$1,246 |
$1,501 |
$350 - $420 |
| with polyp removal by snare (45385) |
$1,955 |
$1,552 |
$350 - $420 |
| with biopsy (45380) |
$1,613 |
$1,523 |
$350 - $420 |
| Flexible sigmoidoscopy (45330) |
$318 |
$542 |
$350 - $420 |
| with biopsy (45331) |
|
$1,150 |
$350 - $420 |
| Upper endoscopy (43235) |
$1,026 |
$1,377 |
$490 |
| with biopsy (43239) |
$1,051 |
$1,501 |
$490 |
| with balloon dilation (43249) |
|
$1,574 |
$490 |
| with wire-guided dilation (43249) |
|
$1,516 |
$490 |
| Esophageal dilation (43450) |
$440 |
$1,347 |
$490 |
| Hemorrhoid band ligation, in endoscopy center (46221) |
$415 |
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Required Disclosures
In compliance with Colorado SB 17-065 we disclose "that the health care price for any given health care service is an estimate and that the actual charges for the health care service are dependent on the circumstances at the time the service is rendered."
If you are covered by health insurance, you are strongly encouraged to consult with your health insurer to determine accurate information about your financial responsibility for a particular health care service provided at this health care facility. If you are not covered by health insurance, you are strongly advised to contact Digestive Health Associates' Billing Office or Southwest Endoscopy Center's Billing Office to discuss payment options prior to receiving a health care service from this health care facility since posted health care prices may not reflect the actual amount of your financial responsibility.
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