Published evidence documents per-polyp surcharges in US practices and a Canadian private clinic, while a Chinese study records treatment totals of a few thousand yuan. Real US cases also show why hospital charges, negotiated prices and patient payments must be compared separately.
US per-polyp charges are documented
AltaMed publishes a cash-patient guide to gastroenterologists in Orange County, California. Several entries explicitly add a charge per polyp to a basic colonoscopy price. These are patient-facing prices, not an inference from insurance procedure codes.
The guide is hosted in a 2022 document directory and warns that prices can change. These are historical advertised charges, not verified 2026 quotes or paid patient bills. Its short entries do not fully explain whether each supplement covers removal, pathology, or both.
| AltaMed guide entry | Published colonoscopy price |
|---|---|
| Entry 3 | $1,000 + $75 per polyp |
| Entry 6 | $550 + facility fee + $150 per polyp |
| Entry 11 | $1,275 + $100 any polyp / por pólipo |
$100 per specimen is a different charge
Southwest Gastroenterology in Albuquerque separately describes external pathology as an estimated $100 per specimen. It lists physician, facility, pathology and anesthesia fees. A pathology specimen is not automatically the same billing unit as one polyp; the actual specimen handling and invoice matter.
US prices also include bundled models. Sina Health currently advertises a $1,750 cash colonoscopy including anesthesia, pathology and removal of any number of polyps. This is the provider’s own offer, not an independently verified outcome or a guarantee that every complex case qualifies. Ask about clinical eligibility and additional visits.
A procedure code describes a service for reporting. Applicable payer rules govern claims; a cash quote and a patient’s final payment are separate questions. A coding example alone cannot establish what every hospital charges, and an advertised surcharge does not establish what an insured patient ultimately pays.
Real US bills: two cases, very different patient balances
KFF Health News investigated Tom Contos’s June 2024 diagnostic colonoscopy in Chicago, with polyps removed from two sites. Its December 2024 report reproduces billed and negotiated amounts and links the bill archive. The figures below are from that reporting; the DocumentCloud originals could not be retrieved during this review.
A second investigation concerns Elizabeth Melville’s 2021 colonoscopy in New Hampshire, with one benign polyp removed. Her initial $2,185 responsibility was subsequently reduced to zero after the claim was corrected. The table preserves that outcome. Neither case establishes a price per polyp.
| Bill component (USD) | Tom Contos · 2024 | Elizabeth Melville · 2021 |
|---|---|---|
| Hospital: colonoscopy and biopsy, billed → negotiated | $5,466 → $3,425 | Not separately reported |
| Hospital: lesion removal, billed → negotiated | $5,466 → $1,787 | Not separately reported |
| Gastroenterologist: two billed lines | $1,535 + $1,291 | Not separately reported |
| Anesthesia / pathology: separate amounts | Not separately reported | Not separately reported |
| Total billed | $19,206 | $10,329 |
| Reported negotiated total | $5,816 | $4,144 |
| Patient responsibility, initially | $4,047 | $2,185 |
| Paid / later outcome | $2,381 paid; $1,666 still demanded at publication | $0 patient responsibility after reprocessing |
Canada: a clinic explicitly lists $100 per polyp
RocklandMD’s private endoscopy page in Quebec lists colonoscopy with same-day consultation at $1,350, polyp removal at $100 per polyp, and biopsy at $100 per biopsy. Transport and/or pathology charges may be added. This directly documents a removal charge by number. The page uses “$” without explicitly identifying the currency; this is a Canadian clinic, not evidence of a US-dollar quote.
This is a non-RAMQ private service. Its tariff must not be presented as what every Canadian patient pays. Our search did not establish a verifiable Canadian patient receipt for polyp removal. A published tariff, an individual bill and proof of payment are different kinds of evidence.
China’s public prices help establish a pre-treatment budget
Public-hospital prices in China have an explicit disclosure framework. Beijing’s 2026 notice requires public hospitals to follow the applicable tariffs, publish prices and provide inpatient cost lists; unlisted charges are prohibited. Hebei’s digestive-service schedule also requires clear price display. Published prices, combined with the planned treatment, give patients a checkable basis for discussing an expected total before care.
A useful estimate specifies the likely range and what it includes: examinations, sedation, removal, pathology, consumables and any planned second session. A later change in treatment can change the total; that does not make the initial budget unknowable. The study below supplies evidence of actual historical treatment costs, while the treating hospital supplies the estimate for an individual case.
A few thousand yuan: evidence from treated patients
A 2021 Chinese clinical study by Jin and colleagues compared 879 day-surgery patients with 1,372 conventional inpatients undergoing colonoscopic polyp removal. Its eligibility criteria specified 5–10 polyps. Mean total treatment costs, including outpatient examinations, were CNY 2,968.8 ± 677.2 and CNY 4,122.4 ± 859.5 respectively; the ± figures are standard deviations, not price ranges.
This supports the plausibility of treatment costing a few thousand yuan for selected patients with multiple polyps. It is historical, single-center evidence, not a current national price or a quote for an overseas visitor. Suspected malignant lesions and several higher-risk conditions were excluded. The paper also gives inconsistent recruitment end dates in its abstract and methods. It does not establish the cost of two separate sessions or of removing dozens or hundreds of polyps.
China can also charge more when there are more polyps
Hebei’s 2026 official schedule provides a concrete counterexample to the claim that number never matters in China. Item 013310000040000, endoscopic removal of digestive-tract surface polyps, lists CNY 342 and CNY 308 in its provincial and municipal guidance columns, per anatomical site/session. The basic unit covers up to three polyps; each additional polyp adds 30% of the basic price, with the count capped at ten for this calculation.
That cap applies to this charge, not to the entire treatment bill. The item explicitly excludes the endoscopic examination. Deeper lesion resection has a different item and price. These are local tariff components, not complete hospital packages, insured copayments or a nationwide promise to remove an unlimited number for one fee.
Two sessions can be plausible; two sessions are not a cure guarantee
Staged removal is an established possibility: an archived 2019 German colorectal-cancer guideline explicitly allows multiple polyps to be removed over more than one session. This historical guidance supports the plausibility of staging, not a fixed two-session plan for an unidentified patient.
NIDDK explains that removed tissue is examined and follow-up depends on the number, size and findings of the polyps. Some patients need surgery or further colonoscopies. Polyp count alone cannot determine treatment, total cost, or whether care is complete.
Compare the whole bill before comparing countries
Ask both providers for a written estimate separating the endoscopist, facility, sedation, removal, pathology, consumables and any second session. Confirm whether a supplement is per polyp, per specimen, per site or per visit, and whether a cap applies. Compare full self-pay totals with full self-pay totals, rather than one country’s insured copayment with the other’s listed charge.
For care abroad, add travel, accommodation, interpretation, follow-up and possible extra treatment. The evidence supports the existence of per-polyp US quotes and lower-cost Chinese treatment examples. It does not establish a particular person’s bill, inability to afford care, or savings for an equivalent case today.
Sources and scope
Sources checked on 3 October 2026. This article examines pricing evidence and clinical plausibility; it does not verify an individual patient’s story. Historical figures are dated, provider offers are attributed, and no provider is recommended. Clinical decisions require assessment by qualified clinicians.
- AltaMed · Orange County cash-patient guide ↗
One-page guide, entries 3, 6 and 11. Historical document in a 2022 directory; not a current quote. Entry 11 uses the less precise English wording “any polyp” alongside Spanish “por pólipo”.
- Southwest Gastroenterology · Insurance and Billing ↗
Provider-published baseline estimate for external pathology, not a confirmed invoice or a national rate.
- Sina Health · Price Transparency ↗
Provider-published self-pay offer. Availability, suitability and complex-case exclusions require confirmation.
- CMS · 2026 Medicare NCCI Policy Manual, Chapter VI ↗
Section C.3 governs reporting repeated endoscopic procedures under Medicare. It is not a survey of hospital cash prices or individual patient bills.
- Jin et al. · Clinical value of daytime colonoscopic polypectomy (2021) ↗
Original clinical study, sections 1.1 and 2; DOI 10.11569/wcjd.v29.i20.1174. Selected patients with 5–10 polyps; reported total treatment costs, not a verified foreign-patient quote.
- Hebei Medical Security Bureau · 2026 digestive-service tariffs ↗
Ji Yi Bao Han [2026] No. 16, PDF page 18, item 013310000040000. A local maximum service tariff with number-based additions; the endoscopy examination is excluded.
- German Guideline Program in Oncology · Colorectal Cancer (2019) ↗
Archived, expired 2019 edition, recommendation 6.6. Cited only to establish that staged removal is a recognized approach, not as current personalized treatment guidance.
- NIDDK · Treatment for Colon Polyps ↗
US National Institutes of Health patient information on removal, tissue examination and follow-up.
- KFF Health News · Tom Contos billing investigation (2024) ↗
Reported totals do not fully reconcile: $1,979 insurer payment plus $4,047 patient responsibility differs from the reported $5,816 negotiated total. The report acknowledges this; we have not silently corrected it. Other individual charges are not fully itemized in its text.
- KFF Health News / NPR · Elizabeth Melville billing investigation (2022) ↗
Published 31 May 2022 about a 2021 procedure. Includes the insurer’s confirmation that the corrected claim left no patient responsibility. The initial balance is not a final paid receipt.
- RocklandMD · Private Endoscopy Clinic, Quebec ↗
Provider’s own published tariff for a private non-RAMQ service, checked 3 October 2026. It is not a patient invoice; the page prints a dollar sign without an explicit currency code.
- Beijing government · 2026 medical-service price disclosure requirements ↗
Official explanation of price rules effective 27 June 2026. Supports price disclosure and itemized inpatient charges, not a guaranteed total for every operation.