The bills and insurance statements for my ear/skull/brain surgery are starting to roll in, and one thing’s certain: The amount medical providers charge my insurance company is hugely different than what they charge me. I guess this is part of what people talk about when they say the US health care industry is a mess. It seems weird and dishonest for someone to send out a bill for a service that’s 10 times as much as what they expect to actually get paid. If my auto mechanic or plumber or barber or realtor did that, I’d think they were crooked. But it’s standard operating procedure in health care, apparently.
So I thought it might be fun to take a betting pool to see who can guess what the total cost of my surgery (and associated medical costs) will add up to be. Anyone interested? Maybe players can choose their guess to the nearest $1000, and I’ll give out a special prize in the end.
The amount wouldn’t include peripheral costs like travel expenses for us to travel to and stay in Louisiana for the surgery, but it would include all the regular, every day, billed prices for all the services I used. So, for example, if a tiny bottle of prescription ear drops costs me $20 through my insurance company’s prescription drug benefit, but says “Every day price: $126.17” then we’d count the larger amount for the purposes of this game. Anyone wanna play?
If not, I probably won’t bother to add up the number, because it’s kind of a pain in the ass to go through the paperwork and figure out the “regular, every day” prices for things.
I’d play, but I’m privy to the inside information.
Well Todd, I will take a shot at it. I am keeping in mind that in the south– prices may be different than in the north and so I am shaving a smidge cost off due to that but not must cause your doc is very specialized and this must be a well known teaching hospital. Lots of guessing going on here.
These are guesses–
operating room charges as follows
opertating supplies–$2,700
crani–$6,900
microscope use–$1,400
microscope supplies-$235
anesthesia drugs–$2,000
anesthsia supplies–$350
respiratory–$550
SEP’s–evoked potentials–$1,500
recovery–$1,300
drugs during surgery–$1,700
monitor use during surgery–$500
recovery–$1,200
incidentials—-$900
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now for your room charges
I will guess $1,250 a day for a private in ICU
I think you were there 3 days right? so–
$3,750 but I am not sure if you left ICU and moved to a step down unit which would be cheaper. Let me know on that one.
Drugs in room–$1,100
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now for the actual doctor charges
crani–$5,000
SEP’s–one for each day you were there I would guess but they only charged for one–so $250
Anethesia MD–$2,000
room visits were free from ENT but not nuero so
nuero visit–$200
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are we counting go home drugs? if so I will go with around $750 that does not include OTC
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now you did not mention if this included testing before or after surgery so I did not add that in
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for good measure I will throw in a incidentals charge of oh let’s say–$6,000 because you had CSF biz and there are other things I am sure I can’t think of.
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how am I doing so far? Anywhere close? I think this brought it to about $40,000.
I will be anxious to know how far off I really am. 🙂 Let me know Todd. Hope all is going well.
Wow, that’s a very detailed justification. If they went into that detail on The Price is Right, there would be no time left for commercials! 🙂
Let me give you a few clues to help you refine your estimates.
First, I was in the hospital only 2 days, not 3. The first night was in ICU and the second night was in a regular room.
Second, the operation was done at North Oaks Medical Center, which is not a teaching hospital and is not associated with a university. It’s just the regular hospital for the area around Hammond, Louisiana.
Just for grins, let’s include the cost of any pre-op tests up to one week before surgery, whether they were done at the surgeon’s office or at the hospital or elsewhere. Also, we’ll include the costs of all the medicines I had to take after surgery; that includes meds in the hospital and after I got home (which in my case was a hotel room for a week and then my real home). And yes, we’ll include the costs of dealing with my CSF pressure and anything else ordered by my surgeon within one month of the surgery.
I’m still waiting to see if others want to play. If we don’t have at least 3 players, I won’t bother to add up the numbers because it’ll take me a couple hours to sort through all the receipts and bills and stuff.
I’ll take a straight shot at this and say at least $80,000. That’s including surgeon and anesthesiologist, special nurses, all drugs, etc. – all the things you mentioned. Pre-testing too.
Don’t add up all the slips unless you get a huge influx of these responses. Just guestimate it. I’d hate to cause you two or three hours – except you’ll need to do it sooner or later either for taxes or for the insurance company. Or both.
We’re glad you’re doing well….
Joan D.
So what’s this math question? I asked if the answer was the same as 2+2 and a response said I’d flunked. Hmmmmm.
Hi, Joan. The mandatory math question is just a simple way to keep comment spam bots away.
No, I don’t need to add up the “every day” price of everything for insurance. I’ll only add up the actual prices I paid (which will be much lower in nearly every case), both for insurance reasons and for tax reasons.
Okay so my revised costs —give and take— bring me to $71,000.
So far it’s just Joan and Violet. If I see another 1 or 2 people interested, then we’re on. Otherwise, I don’t think it’s worth it to do all the math. But I think your guesses are probably in the right ballpark!
I am having the surgery done this Wednesday, December 7th, and was told about your site form a referral patient my surgeon gave me. I have been curious about the priceand since I have had a knee, shoulder and kneck surgery in the past 4 years, I am guessing this will be quite a bit more. I am guessing $95,000 everything included. Any tips or advice on my upcoming surgey would be greatly appreciated. Thanks, Dave
Well, as far as tips and advice go, the absolute best place to get information about SCDS surgery is here: http://scdssupport.org.
Regarding the cost, I honestly never calculated an exact cost, because it’s impossible. Originally, when I asked this question, I was under the naive impression that a cost is a cost is a cost. But then I learned the dirty not-so-secret of the health care industry, which is that there’s no single price for anything. There’s the amount the service provider says the service costs, there’s the amount they actually bill the insurance company, there’s the amount the insurance company actually pays, and there’s the amount they would have charged you if you were paying in cash instead of using an insurance company. Once I learned how variable prices are, I just gave up trying to compute the sum. I think my insurance and I were billed about $70k, and I think we actually paid about $40k.