Required Egd Test Next Week. Cost? Help

[Cobrargc 25]

I'm having my surgery in Kansas City soon. I live about 3 hours away from KC and to prevent another 3 hour drive to KC the clinic suggested I have an EGD test done near home. The test is set up for next Wednesday. My insurance will not cover the bariatric surgery, but should cover some of the cost of the EGD test. I was stunned when I ran a cost estimate for the procedure through the Alegent Health website. We are in a new year and none of my deductible has been met. The cost estimate tells me my out of pocket for the test could be between $1450-1850 and at the bottom of the page there was a disclaimer that said "Professional fees (such as physician, anesthesiologist, radiologist, pathologist) not included in this estimate will be billed separately." Is Kansas City and the local Alegent hospital on the same page? When all the costs are in for this test, this could raise the final cost of my surgery by 25%. This is crazy and a possible deal breaker for having the surgery here in the states.

Is anyone familiar with this test? I believe they run a camera into the stomach to look for ulcers and to take a small sample to check for GERD. Is this test that expensive. Like most folks, I only have a certain amount of money set aside for the surgery and this test might force me to look elsewhere.

[PEvette 297]

my doctor ordered one for me as well, I've taken one before when my primary doctor was trying to figure out my gallbladder problem....the test is pretty expensive because they have to put you under for about an hour...and if they find anything the doctor will send it to pathology which is a huge bill itself....why cant your doctor ICD it to test for acid reflux, instead of baratric??? I would call and ask...

[vsgchichi 48]

Hi in CA and mine cost about $1100 my insurance at the time wouldn't cover

[Cobrargc 25]

How would a person even go about shopping around for EGD prices? Part of the reason it's expensive is because it's done at a hospital. They need to make sure they get their piece of the pie. Would this procedure be available in an outpatient surgical clinic, where the cost might be reduced? Is it nothing more than a reverse colonoscopy? They can't all be done in an overly priced hospital operating room.

Would it be possible to get a doctor to order the test in a way that might get my insurance to pay a portion? It's shameful when an insurance company, which stands to benefit the most financially with fewer future claims, doesn't want to help out in any way.

[happy1957 138]

I too had a required EGD, they where looking for ulcers, H-Pylori, Hiatal Hernia and any other types of abnormalities that could later cause issues with your new tummy.

I just looked up the cost on my ins website... charges were 537.00 paid 376.50 for the Dr. 4186.94 paid 4186.94 for the hospital and 253.00 paid 233.00 for the pathologist. I believe the anesthesiologist was part of the hospital and not billed separately because they are now a hospital owned group. I think if you run it through your insurance they will pay for it especially if they find something or you already have a diagnosis such as acid reflux. If the Dr codes it as obesity, they may reject it, but running it through forces the providers to accept the "customary charges" opposed to the full charges as listed above. I actually was surprised to see how close the charges were. to to the actual allowed. My Dr charged 4190.00 for the actual VSG surgery and was only paid 1607.32. I personally think that is a little low considering the detailed, excellent care and responsibility that she had. My suggestion to you is ALWAYS run everything through your insurance no matter how insignificant it seems. I wish you the best.. It'll all be worth it in the end.

[happy1957 138]

Hi in CA and mine cost about $1100 my insurance at the time wouldn't cover :smile1:

Wow!! Cheap in comparison to mine.

[Tshaunda 14]

Dont let this hold you back!! I paid and still owe for my EGD. I have insurance, Good insurance. I paid the hospital 500 so far, got a bill that i owe 500 more. So 1,000 with insurance. I look at my insurance claim they claim the proceduere at 10,500 dollars but my insurance only paid 1,400 for it. I also see there are some other separate doctor bills that i have not gotten a bill for. The hospital worked with me on payment letting me pay half, and as for the other bills I havent got them yet but I am not going to worry about that at all until after my surgery!!