How Much Does a Gastroenterology Visit Cost?

When your digestive system isn't working quite right, you know it.¹ And if you're dealing with constant gastrointestinal distress with symptoms like abdominal pain, acid reflux, constipation or diarrhea, it might be time to visit a gastroenterologist.²

Keep reading to learn how much these specialist visits can cost and what to expect at a gastroenterology appointment.

What Is Gastroenterology?

Gastroenterology is a specialized area of medicine that focuses on the digestive system.² (“Gastro" refers to the stomach, “entero" refers to the intestines and “ology" means “study of.")¹ Beyond the stomach and intestines, there are several different organs in the digestive system that work together to break down food, absorb nutrients and remove waste.¹

What Do Gastroenterologists Treat?

Gastroenterologists treat gastrointestinal conditions and diseases, which encompass issues with the gastrointestinal (GI) tract (esophagus, stomach and intestines) and biliary organs (bile ducts, liver, pancreas and gallbladder).¹

Conditions that gastroenterologists treat may include:¹

• Celiac disease
• Cirrhosis
• Colitis²
• Colon polyps and colon cancer²
• Food allergies and intolerances
• Gallstones
• Gastroesophageal reflux (heartburn)²
• Gastroesophageal reflux disease (GERD)
• Hemorrhoids
• Hepatitis
• Inflammatory bowel disease (IBD)
• Irritable bowel syndrome (IBS)
• Pancreatitis
• Ulcers

10 Reasons to Visit a Gastroenterologist

The most common symptoms prompting a visit to the gastroenterologist are, in order:³

1. Abdominal pain
2. Vomiting
3. Nausea
4. Diarrhea
5. GI bleeding
6. Constipation
7. Anorectal symptoms (e.g., hemorrhoids, anal fissures)
8. Heartburn and indigestion (including gas and bloating)
9. Decreased appetite
10. Difficulty swallowing

If you're experiencing any of these GI issues, your primary care physician may refer you to a gastroenterologist for specialized care.² And if you're over the age of 50, you may need to see a gastroenterologist every 10 years for colon cancer screenings.⁴

How Much Does a Gastroenterology Visit Cost?

For new patients, the national average cost of a gastroenterology visit is $371;⁵ for established patients, the national average cost is about $303.⁶ The cost typically includes a physical exam and a review of your medical history.⁴

However, various factors impact gastroenterology costs, including location, procedure and facility type.⁴

Gastroenterology Visit Costs by Location

In the United States, the cost of a gastroenterology appointment may vary based on where you live.⁴ For example, Medicare pricing for a new-patient gastroenterology visit can range from as low as $53 in Little Rock, Arkansas, to as high as $234 in Anchorage, Alaska.⁷

The following chart reflects Medicare pricing for new-patient gastroenterology visits in cities across the U.S.:⁷

Keep in mind that Medicare rates are typically much lower than private insurance rates, so the amount you see on your bill may be closer to the national average of $371 than this chart suggests.⁸

Gastroenterology Costs by Procedure

If you need any specialized services to assess your digestive health — such as a colonoscopy or endoscopy — you will likely pay more for your gastroenterology visit. Any of these tests or procedures can add to your total cost.

Here's an overview of the average costs of services frequently performed by gastroenterologists:⁴

Gastroenterology Costs by Facility Type

The cost of a gastroenterology visit also depends on where you see the doctor, whether it's in a hospital, outpatient clinic or office setting.⁴ Typically, a hospital visit costs more than a trip to the doctor's office.⁴ A hospital outpatient visit may also be more expensive than an ambulatory surgery center appointment.⁹

For example, the average Medicare cost of a diagnostic colonoscopy is about $589 in an ambulatory surgery center, as opposed to $981 in a hospital outpatient department.⁹ But remember, Medicare rates are usually lower than private insurance rates,⁸ so the bill for your colonoscopy may fall within the $1,250 to $4,800 range referenced above.⁴

Gastroenterology costs at an ambulatory surgery center

Here are the national average Medicare costs of the five most common GI procedures in ambulatory surgery centers:⁹

Gastroenterology costs at a hospital outpatient department

Here are the national average Medicare costs of the five most common GI procedures in hospital outpatient departments:⁹

Does Health Insurance Cover Gastroenterology Visits?

If you have health insurance, you may need a referral from your primary care physician before you can see a gastroenterologist.¹⁰ Without that referral, the insurance company may not cover the cost of the visit.¹⁰

In addition, it's a good idea to go to an in-network gastroenterologist to save money on care.⁴ Out-of-network providers and facilities are typically much more expensive than in-network options.⁴

How to Prepare for Your First Gastroenterology Visit

Before your first gastroenterology appointment, make a list of your symptoms to share with the doctor and be prepared to answer questions such as:¹¹

• When did your symptoms start?
• How long do your symptoms usually last?
• Does anything seem to trigger your symptoms?
• Do your symptoms get better or worse at certain times?
• Have you tried any treatments for your symptoms?
• Have you had any other illnesses or surgery?
• What medications are you taking?
• Do you have any allergies?
• Do you have a family history of digestive diseases or other health problems?

What to Expect at a Gastroenterology Appointment

Here's what to expect during the physical exam:¹¹

• You'll lie down on an exam table.
• The doctor will press down on your abdomen, feeling for any masses or tenderness.
• The doctor will listen to your breathing, coughing and bowel sounds.
• If you have colorectal symptoms, the doctor may insert a finger into your rectum to feel for any bulges or masses, and to assess the muscle tone.

Your first appointment with a gastroenterologist may take between 30 and 60 minutes, but subsequent visits could be shorter.¹¹

Follow-up exams

After the physical exam, your gastroenterologist may recommend follow-up tests to gather additional information. These tests may include:¹¹

• Blood test
• Stool test
• CT scan
• GI tract X-ray

If you need a GI tract X-ray, your doctor may give you a barium swallow or enema first to highlight areas inside your body such as your esophagus, stomach, upper small intestine, colon or rectum.

Do You Need an Endoscopy?

If your gastroenterologist needs more information to properly diagnose and assess your GI condition, they may perform an endoscopic procedure. During these non-surgical exams, the doctor inserts an endoscope — a tiny camera on the end of a long, thin tube — into your body. Not only can endoscopy exams give your gastroenterologist a detailed view inside your body, but these exams may also allow the doctor to:¹

• Take tissue samples (biopsies)
• Remove tumors
• Relieve blockages
• Open up narrow channels
• Stop bleeding

By passing tiny tools through the endoscope, gastroenterologists can perform these minor interventions to treat your GI condition without invasive surgery.

3 common endoscopic procedures

Common endoscopic procedures include:

• Upper endoscopy. During this exam, the endoscope goes through your mouth so the doctor can look at your upper GI tract¹¹ from your throat to your stomach to your upper small intestine.¹ Your doctor may recommend an endoscopy if your symptoms include persistent heartburn, abdominal pain or vomiting.¹¹
• Colonoscopy. This exam of your lower GI tract¹ involves putting the endoscope into your bottom to look for polyps or bleeding, remove polyps (polypectomy)¹ or take a biopsy.¹¹ You may need a colonoscopy if you have persistent abdominal pain, constipation or diarrhea or blood in your stool.¹¹ A colonoscopy can detect colon cancer or polyps.²
• Enteroscopy. During this exam of your small intestine,¹ you will swallow a tiny video capsule that will take pictures of your digestive tract.¹¹ Your doctor may perform an enteroscopy if an endoscopy or colonoscopy is inconclusive.¹¹

What to Expect After Your Gastroenterology Appointment

Your gastroenterologist may prescribe medications and recommend lifestyle changes to manage your GI symptoms. Depending on the diagnosis, tips may include:¹¹

• Avoid foods that trigger symptoms.
• Limit caffeine.
• Exercise regularly.
• Find healthy ways to manage stress.
• Go to the bathroom as soon as you have the urge.

How to Find a Gastroenterologist

Need help finding a doctor? Here are some tips to help you choose a gastroenterologist:¹²

• Ask for recommendations. Talk to your primary care physician, family, friends and other healthcare providers to get a list of gastroenterologists they trust.
• Verify your insurance coverage. If you have insurance, check to see which doctors on the list participate in your plan. Choosing an in-network provider can help you pay the least out-of-pocket costs for care.
• Check their credentials. It's important to choose a gastroenterologist who is board-certified to ensure they have the necessary training and skills. You can use the American College of Gastroenterology's lookup tool to find a board-certified gastroenterologist near you.
• Read patient reviews. You can gain a lot of insight into a practice by reading about other people's experiences with appointment scheduling, wait times and the general office environment, as well as how much time the doctor typically spends with each patient and how well they answer questions.
• Request a consultation. If you have a complex GI problem, you'll want an experienced doctor to help ensure as positive an outcome as possible. Ask the doctor about their recent training and experience with your specific condition.

In the end, you'll want to choose a gastroenterologist with whom you feel comfortable — one who welcomes questions, considers your treatment preferences and respects your decision-making process.

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Author Bio

Robyn Tellefsen is a freelance writer and editor with more than 20 years of experience covering health and wellness, finance and more. Her work has appeared on sites such as LoopNet, Beachside Rehab, First Horizon Bank, SoFi, A Place for Mom, American Express, Chase and more.