SPOTLIGHT: New Research Shows Hospitals Charge 50% More in Facility Fees

According to new research published in JAMA Health, facility fees for colonoscopies at hospitals were 50% higher than ambulatory surgical centers (ASCs) in the same county and with the same insurer.

The study’s researchers found:

  • Hospitals charged average facility fees of $1,530 for a colonoscopy, $1,760 for a colonoscopy plus a biopsy and $1,761 for a colonoscopy as of May 2023.
  • At an ASC, the same three items were $989, $1,034 and $1,030 respectively– meaning hospitals’ facility fees were 54%, 56% and 61% higher across the three procedures.


Researchers suggest “a site-neutral payment policy for a largely homogeneous and shoppable service may generate savings for commercial plan sponsors and beneficiaries.”

The nonpartisan Congressional Budget Office projects that paying physicians the same for drug administration at on- and off-campus facilities saves $3.74 billion, while requiring off-campus hospitals to have a separate identifier than the in-patient hospital saves $2.32 billion.

Better Solutions is supportive of specific provisions in the Lower Cost, More Transparency Act that just passed the House. These provisions would help drive down healthcare costs and increase transparency for patients.