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Package

Colonoscopy with endoscopic mucosal resection

Package

Colonoscopy with endoscopic mucosal resection

Colonoscopy with endoscopic mucosal resection (EMR) uses a colonoscope to remove abnormal tissue from the inner lining of the colon, most often used when larger or flat polyps cannot be removed with standard techniques. The abnormal area is first lifted using a fluid injection to separate it from the deeper colon wall, and the tissue is then removed in sections. You will receive sedation and will need bowel preparation beforehand. This approach allows for removal of more complex lesions without the need for open surgery.
You'd pay up to
$4,218 / Case Rate

A single, all-inclusive pricing methodology for a procedure in healthcare contracts, instead of separate charges for each service.

The estimated total cost of care without any insurance coverage or discounts.

$4,218

Without insurance

What goes into a price?

Negotiated prices across insurers

Lowest
$1,952
Highest
$6,247
Cash price
up to $4,218

Self pay or cash prices vary by facility when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts facilities charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.

Procedures included in this package

This list includes the services and fees bundled into the Colonoscopy with endoscopic mucosal resection Standard Service Package (SSP GA005). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.

Code Code Type Description
HCPCS 45390 Facility Fee Flexible Endoscopic Colonoscopy with Mucosal Resection
HCPCS J3490 Facility Fee Pharmaceuticals without Categories
HCPCS 85027 Facility Fee Complete blood count (CBC) – basic blood cell count
HCPCS J7030 Facility Fee Intravenous infusion of 1000cc of normal saline
HCPCS 83735 Facility Fee Inorganic ionic element essential for body functions
HCPCS 71045 Facility Fee X-ray of chest for viewing single structure
HCPCS 83550 Facility Fee Serum test for total iron binding capacity (TIBC) which measures ability to bind to iron molecules
HCPCS 80048 Facility Fee Basic metabolic panel including calcium, bicarbonate, chloride, creatinine, glucose, potassium, sodium and BUN
HCPCS 43239 Facility Fee Flexible Transoral Examination of Esophagus, Stomach & Duodenum with Biopsy
HCPCS G0378 Facility Fee Hospital observation service rendered hourly
HCPCS 83540 Facility Fee Elemental iron atom with modifications of electrons
HCPCS 84100 Facility Fee Inorganic phosphate measurement in urine
HCPCS 36415 Facility Fee Collection of blood from a vein via puncture
HCPCS J2250 Facility Fee Intramuscular injection of 1mg midazolam hydrochloride
HCPCS J2765 Facility Fee Intramuscular Injection of Up to 10mg Metoclopramide Hydrochloride
HCPCS J1756 Facility Fee Injection of Iron Sucrose, 1mg per Dose
HCPCS 85007 Facility Fee Laboratory Blood Smearing and Differential Wbc Count
Revenue Code 250 Facility Fee Pharmacy (Also see 063X, an extension of 250X) - General

Disclaimer

Southern Ohio Medical Center is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.

In compliance with federal law, we provide a list of standard charges that are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient's unique needs.

You'd pay up to
$4,218 / Case Rate

A single, all-inclusive pricing methodology for a procedure in healthcare contracts, instead of separate charges for each service.

The estimated total cost of care without any insurance coverage or discounts.

Disclaimer

Southern Ohio Medical Center is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.

In compliance with federal law, we provide a list of standard charges that are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient's unique needs.

What’s the difference between an individual procedure and a Standard Service Package (SSP)?

Individual Procedure

Individual procedures, like blood tests, each have unique prices and billing codes (like a CPT or HCPCS code). While they can be billed alone, they're usually grouped with other procedures on a claim. This grouping is what determines the total cost of your care.

Standard Service Package (SSP)

A SSP combines all medical services, materials, and fees associated with a healthcare visit or procedure into a single bundle to offer a more comprehensive estimate.

Contact us to verify your estimate

Have your service name, codes, and payment preference ready. If you’re using insurance, you may be asked for insurance details like your Member or Group ID.

Service Colonoscopy with endoscopic mucosal resection
Service Codes HCPCS 45390, HCPCS J3490, HCPCS 85027, HCPCS J7030, HCPCS 83735
Insurance I'm not using insurance
Location Southern Ohio Medical Center
When you contact us, you can say:
"Hi, I'm calling to verify a price for Colonoscopy with endoscopic mucosal resection I found through Southern Ohio Medical Center's price estimate tool. Here are the codes I’m looking at: HCPCS 45390, HCPCS J3490, HCPCS 85027, HCPCS J7030, HCPCS 83735. I'm not using insurance, can you confirm the cash pay estimate and help me schedule if needed?"
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