Endoscopy cost
Expert tips for endoscopy costs
Our health insurance expert, Steven Spicer, is here to provide some tips for choosing the right health insurance to help with your endoscopy costs.
Steven Spicer
Executive General Manager – Health, Life & Energy
Choose the right cover for your lifestyle
We’re all unique, so there isn’t a universal policy to suit everyone. When looking at health insurance products, consider your health, lifestyle, family history and the type of services you’ll likely need. This will help you choose a policy that provides the necessary cover without needlessly spending extra money.
Adapt your policy as you go
As you go through life, your health needs are going to change. Luckily, you can change your health insurance to adapt to your changing requirements. If it’s been a while, take a look over your policy; you might find a few services you’re paying for that you no longer need. Likewise, you might realise you aren’t covered for something you may need in the future.
Consider plus products
Many private health insurers will offer more coverage through ‘plus products’. These policies offer the required minimum inclusions with additional coverage. You may find a Plus Policy that provides the coverage you need without needing to pay the higher premiums of the next tier. If you need any assistance, talk to an expert who can help you compare!
What is an endoscopy?
An endoscopy is a procedure where a doctor passes a thin camera into your body.1 The purpose is to give your doctor a direct view of your internal organs, which can help diagnose and treat various conditions. Though usually not a painful procedure, your doctor will give you a light sedative or anaesthetic before beginning.
The endoscope is a thin, flexible tube with a light and camera at the tip.1 The tube is usually entered through either a small incision in your skin or a natural opening in your body, such as your mouth, urethra or anus. The procedure’s doctor will be a gastroenterologist for digestive issues or an orthopaedic surgeon for an arthroscopic procedure.
Specially designed endoscopes can be used for surgical purposes, including:2
- Taking tissue samples for a biopsy
- Finding, sampling or removing tumours or polyps from the lungs or digestive tract (intestine)
- Finding and removing foreign objects from the body
- Removing stones from a patient’s bile duct
- Placing tubes through blockages in areas including the oesophagus, bile duct, duodenum or colon.
Whether you’ll need to stay overnight at the hospital will depend on the type of endoscopic procedure you’re receiving. Recovery time for most patients is between a few hours and a couple of days.
Types of endoscopy procedures
There are many types of endoscopy procedures, each defined by where in the body the endoscope enters and the purpose of the examination. Some kinds of endoscopy include:1,2
- Arthroscopy – Enters through the skin to examine a joint such as your knee, elbow, hip or ankle.
- Bronchoscopy – Enters through the mouth to examine your lungs and airways.
- Capsule endoscopy – Involves swallowing a tiny capsule that contains a camera that will film the digestive tract.
- Colonoscopy – Enters through the anus to examine your bowel (colon).
- Gastroscopy – Enters through the mouth to examine your stomach and oesophagus.
- Duodenoscopy – Enters through the stomach into the duodenum to examine and perform procedures on the bile duct and pancreatic duct. Also called ERCP (Endoscopic Retrograde Cholangio-Pacreatogram).
- Hysteroscopy – Enters through the vagina and cervix to examine your uterus.
- Cystoscope and ureteroscopy – Enters through the urethra to inspect your bladder.
- Laparoscopy – Enters through your skin to see inside your pelvis and abdomen.
How much does an endoscopy cost?
Numerous factors influence how much your endoscopy will cost, including your doctor’s fees, the type of procedure you’re undertaking and which healthcare facility you choose.
Cost of an endoscopy in a private hospital
The below table shows the cost of endoscopy by type of procedure.3
| Type of Endoscopy | Medicare Benefits Schedule Item Number(s) | Typical specialist fees | Median amount of specialist fees covered by Medicare | Median amount of specialist fee covered by insurer | Median out-of-pocket costs (paid by patient) |
|---|---|---|---|---|---|
| Bronchoscopy |
38423 38420 38419 |
$1,300 | $530 | $520 | $230 |
| Colonoscopy |
32224 32223 32222 32228 32225 32226 |
$1,300 | $580 | $470 | $180 |
| Cystoscopy (inspection only) |
36818 36821 36812 |
$800 | $280 | $290 | $240 |
| Gastroscopy |
30478 30473 |
$970 | $430 | $370 | $150 |
| Hysteroscopy | 35633 | $1,200 | $410 | $400 | $340 |
| Laparoscopy |
35631 35637 35638 |
$2,800 | $1,100 | $990 | $520 |
|
Source: Australian Government Department of Health and Aged Care: Medical Costs Finder. Accessed 20243 |
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The above numbers don’t include hospital fees such as anaesthetist fees; your health fund will cover some or all of this cost, but depending on your level of coverage, there may be some out-of-pocket expenses.
Does private health insurance cover an endoscopy?
Gastrointestinal endoscopies, colonoscopies and hysteroscopies for a series of MBS items are included in Bronze level hospital cover. Arthroscopic surgeries for some joints falls under the category of joint reconstruction or bone, joint and muscle, depending on the procedure (e.g. whether it’s in the hip or knee). Both categories are part of the minimum requirement of Bronze level hospital cover, which means these procedures are also included in both Silver and Gold tiers as well.
Does Medicare cover an endoscopy?
If you go through the public hospital system as a public patient, the entire procedure will be covered by Medicare. While at first this seems like a great deal, there are some downsides. The public waiting list can be incredibly long; depending on your procedure and where in Australia you’re being treated, you could end up waiting months for your treatment. You’ll also have little say on where your procedure takes place and who performs it.
Meet our health insurance expert, Steven Spicer
As the Executive General Manager of Health, Life and Energy, Steven Spicer is a strong believer in the benefits of private cover and knows just how valuable the peace of mind that comes with cover can be. He is passionate about demystifying the health insurance industry and advocates for the benefits of comparison when it comes to saving money on your premiums.
Want to learn more about health insurance?
1 Health Direct – Endoscopy. Accessed September 2024
2 Better Health Channel – Endoscopy. Accessed September 2024
3 Australian Government Department of Health and Aged Care: Medical Costs Finder. Accessed September 2024.