is a colonoscopy covered?

Hello,  I'm a retired AT&T employee.... ID # -, Group # 

I'm in need of a colonoscopy.  I called BCBS of Ill and was told my 5 year test is covered yet the colonoscopy place says I need to pay $800 plus $600 as my colonoscopy is 'diagnosis' vs 'routine' because I had polyps removed 5 years ago.  My wife had the same scenario and paid >$100 in 2022.   I need to know why Gastrologist office is not labeling my procedure as 'routine' vs 'diagnosistic'.  Seems like a routine colonoscopy from my view.  

If I am out of pocket $1,400 for diagnostic.......Can I go to a new place for a 'routine' colonoscopy to lessen my out of pocket?

thanks!  Tim 

  • Hi Tim, We ask that you please edit your post to remove your Id number in order to keep your information secure.

    You will need to speak with your provider to see why they are labeling your procedure as diagnostic, as they are the ones who determine that. It would also be up to any other provider you see to determine how they would bill their claim if you switched to them for your procedure. ~ KW