You may wish to consider the following in your choice of an endoscopy center:
Comparing fees and contract rates among healthcare facilities is difficult for patients because of the complexity of current health care industry charge systems and the confidentiality mandated by health plan contract terms. Ambulatory Surgery Centers, such as the Southwest Endoscopy Center, will typically use a comprehensive, or global, charge that reflects all services, drugs and supplies needed to render the anticipated care. Hospitals charge differently, typically itemizing their fees for supplies and drugs as well as time-based charges for use of each hospital room or area needed (preparation, endoscopy, recovery). A facility's "retail" fee is usually quite different than the contract rates it may have negotiated with health plans, which will vary from plan to plan. Our staff will help you try to estimate your potential out of pocket liability based on the services we anticipate providing, our contract rates, and your insurance coverage (reflecting your copay and deductible obligations).
Some insurers are now assisting their plan members or subscribers by providing online estimates of typical prices for common services. Please contact your own health plan or check its website for applicable details.
As an example, Anthem® Care Comparison (a tool for Colorado's Blue Cross and Blue Shield health plan, Rocky Mountain Hospital and Medical Service, Inc), provided these estimates online on May 20, 2009*:
Screening colonoscopy - Diagnostic tests - Outpatient
For facilities within 100 miles of Durango, CO
Prices based on PPO benefits
| Facility Name
|| Minimum Typical Price
||Maximum Typical Price
| Southwest Endoscopy Center
| Mercy Medical Center
*"This information is applicable to Anthem members only. The information is provided for informational purposes only and does not guarantee coverage in a particular amount. Your benefit coverage will be determined by all of the terms of your health plan, and will ultimately take into consideration factors such as the actual services provided to you, your eligibility, deductibles, co-insurance amounts, any plan restrictions such as authorization or pre-certification requirements and any exclusions or limitations. Additionally, this website presents information relating to a broad number of providers who may or may not participate in the independently contracted network applicable to your particular plan. Please check the appropriate on-line provider directory to determine whether a particular provider participates in your network.
The cost information provided here is based on a methodology Anthem has applied to help predict typical costs for certain services provided related to certain procedures or diagnostics at different facilities. This methodology may be changed from time to time. Your actual cost for the procedure may be different and will depend on the actual services provided and may also vary based on other factors as well such as the complexity of the services rendered, your plan type and Anthem's contractual arrangements with the providers who perform the services for you.
Anthem has used claims information and Anthem PPO contracted facility cost rates to help develop the cost ranges displayed and this information will be updated from time to time and may result in variation of cost ranges reported on this site. The independently contracted provider networks change periodically and provider participation should be verified prior to receiving services. The information on this site is only applicable to the facilities listed. The information is not applicable for Anthem Medicare or Medicaid members, or otherwise where Anthem is not the primary payer."