Table 4.

Cost Scenario of Estimated Total CT Colonography Cost

Scenario	Site of service	Distribution by site, %	Commercial as percentage of Medicare,a %	Adjusted CT colonography screening fee,b $	Ancillary fees,c $	Predicted total cost, $	Time until next screening, yrs	Cost per year until next screening, $	Savings compared with optical colonoscopy,d %
1. Fees with same ratio to Medicare as diagnostic abdominal CTs with diagnostic abdominal CT site-of-service distribution	Hospital outpatient	74	459	1081	359	1440
	Non–hospital outpatient	26	223	526	359	885
	Composite	100	398	937	359	1296	4.9	265	22
2. Fees with same ratio to Medicare as diagnostic abdominal CTs with mammography site-of-service distribution	Hospital outpatient	60	459	1081	359	1440
	Non–hospital outpatient	40	223	526	359	885
	Composite	100	365	859	359	1218	4.9	249	27
3. Fees with same ratio to Medicare as mammography with mammography site-of-service distribution	Hospital outpatient	60	181	426	359	785
	Non–hospital outpatient	40	140	330	359	689
	Composite	100	164	387	359	746	4.9	153	55
4. Fees 200% of Medicare, regardless of site of service	Hospital outpatient
	Non–hospital outpatient
	Composite		200	471	359	830	4.9	170	50

^aThe ratio of the observed 2016 MarketScan commercial fee to the Medicare fee.

^bCommercial as a percentage of Medicare multiplied by the Medicare cost of a diagnostic CT colonography (HCPCS 74261, $235.60).

^cAncillary fees include fees for prescription bowel preparation, pathology, and complications as in Table 3.

^dOptical colonoscopy cost per year until next screening is described in Table 2.

CT indicates computed tomography; HCPCS, Healthcare Common Procedure Coding System.