How Much Does Cologuard Cost?

Written by: Staff

Cologuard, available by prescription only, was developed by Exact Sciences, in collaboration with the Mayo Clinic, and is a noninvasive colon cancer screening test that you’re able to use in the comfort of your own home.

Identifying the altered DNA and/or blood in your stool, which are often identifiers of colon cancer or pre-cancer, the test is able to identify the DNA mutations which were acquired over time in the cells lining the colon.

How much does the Cologuard test kit cost?

The cost of the Cologuard test, as per the official website, as of 2017, was $649 without insurance.   This price is also confirmed by WebMD.

The company does mention that some or all of the test may be covered depending on your insurance plan, but they do recommend you contact your insurance company ahead of time to make sure the test is covered before you have the testing done, asking if they cover CPT code 81528 in particular.  In its FAQ, they do mention the test is covered by Medicare every three years for average-risk patients who are 50 to 85 years old, but for some Medicare patients, a prior authroization may be required and/or you may need symptoms in order to be approved.

Aside from the testing costs, you will still need to consider the doctor’s office visit fee since it is prescription based and the diagnostic colonoscopy if your results were positive.  This test is designed as a screening test only and should not be considered as an official diagnosis.

How the test works

After your doctor writes a prescription, the lab, once they receive the order, will send a collection kit to your address on file.  This test will not be performed inside of your doctor’s office, but rather, inside of your own home so you can collect a sample with ease in private.

No special preparing is required for the test, as per the FAQ, and you do not need to stop taking medications nor do you need to restrict your diet as there are no known issues at this time which may affect the results.  The company asks that you read the detailed instructions before collecting your sample.

To collect the sample, the lab asks you collect a “typical” sample, meaning if you generally have a loose stool, then take it as is, but if you are experiencing stool that’s not normal, such as diarrhea and/or being sick, then the lab asks you wait.

Once you collect your sample, you will be asked to ship it back using the prepaid postage label in less than 24 hours after collecting the sample  As noted by the company, it’s important the sample is delivered to the lab within 72 hours of initially taking the sample, with the company recommending you mail it Monday through Thursday.

Within two weeks of receiving the sample, the lab will send the results directly to your healthcare provider, indicating either a positive or negative results.  Even if you do have a positive result, the company says it does not mean you necessarily have cancer; it only means the test detected DNA and/or hemoglobin biomarkers inside of the stool which are known to be indicators of colon cancer or pre-cancer.  Patients who do experience positive results will often be asked to take a diagnostic colonoscopy, and with these results, your healthcare provider will be able to create the appropriate treatment plan.

Tips to know

Naturally, the lining of the human colon will shed its cells every day, and if there is a presence of cancer or pre-cancer, then these abnormal cell swill shed itself into the colon, eventually excreted in the tool.

Cologuard was approved by the FDA on August 11, 2014, and is available in all states after going through extensive research, including a case study of more than 10,000 average risk study participants.

The test was approved for both men and women who are older than 50 years old and are considered at average risk for colon cancer.  The test is not recommended for everyone and not considered as a replacement for diagnostic or surveillance colonoscopy in high-risk individual, as per the FAQ page.

As per the American Cancer Society, the test is recommended every three years.

The company says both false positives and negatives do occur, but the test can detect nearly 92% of colon cancers.

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Average Reported Cost: $1884

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  1. Mark (17059,  Pennsylvania) paid $1884 and said:

    Total bill paid by insurance (Thank Goodness) was $1,884.00

    Was it worth it? Yes

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