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WoW!!!!!

downinmyheartddowninmyheart Posts: 497
edited 06/11/2012 - 8:26 AM in Back Surgery and Neck Surgery
I just opened my first information statement from the hospital for my TLIF. OMG!! 8} I almost fell on the floor!

I had no idea it was going to be this expensive. Over 6 figures!!! No idea. I really am blown away. I have been in the hospital numerous times before and never came close to this.

Anyone else have this experience?

One Love,

Stephanie
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Comments

  • My surgery was just over 35 grand....they replaced the hardware at L5-S1 and fused L4 to that. Wow...6 figures? I hope your stay was well worth it!! LOL!!
  • my first two surgeries (the fusion and the one to clean out the MRSA 3 weeks later) were 153 THOUSAND DOLLLARS~! then the treatment for the MRSA was insane. I had a nurse come once a week to clean the IV thing in my arm. the vancomycin was incredibly expensive. don't remember those numbers... but yeah... it was really expensive. then I had a third surgery two weeks after the MRSA cleaning (my incision wasn't healing) and I don't remember that figure either. in all, I'm sure it was close to 200 thousand.
    G.
  • Does your insurance pay for that? I wonder why they send a receipt? I don't understand how the system is run there but I'm sure we have in Canada mostly free healthcare. Maybe the waits are long but it sounds like the same there. I worked in Florida a couple of months and after putting an iv in or dressing I had to put a sticker on the wall for how many were used so they could do the billing the next day. Hopefully this system is more upgraded as that was in 1994. I had no idea it cost so much though for one surgery. With 6 figures I wonder if you were staying at a fine hotel. I know it wasn't a joke though. I hope you and everyone are healing well. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • But insurance paid for all but my $100 hospital co-pay and my $20 co-pay to go into the doctors the first time they diagnosed me. THANK GOD FOR INSURANCE!
  • Its a stupid system, but yes they have to bill 6 figures to get paid a quarter of what they bill. If you are concerned about your responsibility is call your insurance company and ask what your "co-insurance", "deductible", and "out-of-pocket" maximum is for the year.
  • My insurance covers 90% on some and 100% on others. I was still astonished though at the price. Outrageous.

    One Love,

    Stephanie
  • Mine was right at $70,000 for the TLIF. My part is somewhere around $1,000...yes, Thank God for good insurance!
  • I just want to thank you guys for sharing this kind of info also.
    More than likely I will be looking at these kind of procedures and bills in the future.

    I priced a 2 level ADR in Los Angeles where I live and it was in the 6 figures. 8}

    Gonna get a passport so I can go get it for less outside the country if need be.
    -----------------------------
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • I live in the UK and we are lucky not to pay for our health care. It may not be a perfect system but hey it's free.

    All we pay for is prescriptions which cost about 12 dollars per medecation.

    Dawn
  • I don't recall the exact amount, but mine was over $60K. My portion because of crappy insurance and deductibles was around $2K.

    I was surprised that the hospital stay was as low as it was - around $1,500 plus meds and a bunch of low cost miscellaneous stuff. The majority truly was for the surgery, both to the surgeon and the hospital for the OR/fluoroscope.
  • Here I am in a small town north of Atlanta, GA. Had a PLIF plus decompression plus bone graft separate incision. Operation took 6 hours. Operated on Tues afternoon and went home on Friday - 3 nights in the hospital.

    And the grand total was (drum roll please) $190,000. My daughter says I'm paying for at least 2 other uninsured surgeries.

    My husband is 60 - I am 56 and our monthly premiums (BCBS) are $1300!!!!! And that's with 5,000 our of pocket.

    Sorry folks but there is something very wrong with this scenerio. Kathy
  • Over 87,000 of my bill is coded to medical supplies. I am guessing because my NS used a name brand system to do this minimally invasive TLIF. I dunno, I am still having sticker shock!

    Kathy, maybe I would feel better if I was paying for two uninsureds with that total,lol.

    One Love,

    Stephanie
  • Kathy,

    What's worse ... did you look at the EOB's from your insurance company? I'll bet your surgeon and the hospital accepted 50%, if not less, than the billed amounts.

    For example, my surgeon billed over $23K just for the surgery. My insurance EOB shows he accepted $5,100 for it!

    The hospital wasn't quite the same ... they billed $37.4K and accepted $23.6K, plus they got $2K from me.

    I would hate to be in the position of needing a spinal fusion and not having any insurance coverage - YIKES!
  • ...that perhaps one of the reasons some of our spinal surgeries are so expensive is that there are a lot of people in the OR during our surgeries, such as nerve monitors, etc. My bill was humongous (3 digits also). The surgeon, hospital, etc. did settle for a portion, so it was discounted about 30-40%. Unfortunately, my company just changed to catasrophic coverage, so my deductible is $8,000. Since it just took effect this last June for only 6 months this year, my deductible was a mere $4,000. That was one of the deciding factors of having my surgery this year. 8}
  • I am looking at paying $8000 for a disc replacement, which insurance won't cover. Along with my copay of $350 for inpatient surgery for the fusion. And of course since the insurance covers the fusion, they will be paying for the hospital, anesthesia and all the extra's that come with surgery. All I am paying for is the cost of the artificial disc and for the surgeon's part in doing that.

    I don't know what the actual total cost of the surgery would be. But I am very happy that I have insurance.
  • Are you thinking of going with the disc replacement then?

    One Love,

    Stephanie
  • Yep, these bills are ridiculous. Just remember the hospital is contracted with the insurance company to accept a lower amount. My hospital stay was $138,000. The hospital settled for $44,000, of which $19,000 went to implants (cage, screws, rods). These implants are horribly expensive, and the hospital only marks them up 5%, because of it. These spinal hardware companies are raking in the bucks. The surgeon bills seperately, and with an Hmo, I have never seen that bill. I did not pay a cent because my 10% copay was written off because I am an employee at the hospital.

    The hospitals receive even less reimbursement from medical and medicare patients. The prices are inflated to make up for all of this. So the poor guy paying privately with cash can be charged an absurd amount.

    Paul, did you check in to getting a reduced price? You can sometimes bargain with the hospital to receive the insurance price when paying cash. I know my mother in law got a hysterectomy for $10,000 cash a few years ago.

    Yep, our crazy healthcare system is a mess, but wow, aren't we fortunate we have one!
  • Stephanie,

    I am leaning toward disc replacement, but I haven't completely made up my mind. I printed out some medical journal articles yesterday, which I haven't read yet, but I'm hoping they will give me more information on which to base my decision.

    I am waiting for a call back from the surgeon, because I have more questions since my consultation. For one, I have no idea what kind of graft material he uses. But I think he said that the FDA doesn't allow 2 level disc replacement, I want to confirm that statement.

    My boyfriend is really pro-disc replacement, though he hasn't been reading these forums or other material like I have. I don't think he grasps the full picture of how much is unknown on the long term benefits and risks of the device.
  • The hospitals have to charge an outrageous amount because a) over 50% of their patients never pay their bill in the first place, and b)when they do bill insurance, they often only get a fraction of what they bill.

    I live in a small town and our local hospital has had to declare bankruptcy. They are still open, but had to close their ER and OB/GYN departments because those where the ones losing all the money...people would come in on emergency and then disappear without paying, or have their babies and never pay their bills. It sucks for those of us who do pay, because now the closest ER is 30+ miles over a steep mountain pass. All of the roads in and out of this valley often close during winter storms (sometimes for days at a time), so I guess we'll have a lot of people having babies at home now!

    As for my ACDF, the hospital billed $38,000. I paid my $2,500 deductible (I only pay $200/month insurance premium) and the insurance paid less than $20,000. That means the hospital got paid less than 60% of what they billed. I received excellent, prompt and skilled care and I'm feeling fabulous, so I actually consider it a bargain.
  • Sue,
    I went to go consult with the famous doctor in Santa Monica who does the Pro-disc ADR's. "Dr. D".
    For now, he would only do a "posterior microdecompression" at L5-S1.
    I then spoke with the billing rep at St. John's hospital next-door.

    She said they(hospital) were willing to give me a 50% discount for cash.

    I have heard a 3 level ADR in Germany is about $30K to $40K cash(US). Depending on exchange rate.
    -----------------------------
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • My insurance co. has an on-line estimator, to tell you what the average cost is in your region (Wisconsin) for surgery. It told me the total would be about $16,327 for "back surgery," which seems WAAAYYYYYY off. Of course, my out-of-pocket cost would be a fraction of that. But still. $16k seems far too low, especially with what's being posted here. We'll see what the actual bill comes to when it's all over.

    Paul
  • You did exactly what I did when I first saw the bill. You could have knocked me over with a feather. Everyone thinks that because I was in an accident with a semi and I have a lawyer that I don't have to pay my part. WRONG! Hospitals and doctors want their money and it's you the patient that they are looking to collect from. They don't care if I have a lawyer or a lawsuit. I didn't do anything to cause this and so far I'm out over 4,000 and I'm no where near done. Your EOB's should start arriving soon though and you will find that the hospital will only get a fraction of what they are asking for because of contractual agreements. You just don't do what I did and go off the deep end and end up depressed over it all. Take a deep breath and wait for all of the bills to pile up nicely and then wait for ALL of the EOB's from the insurance company before you pay anybody anything. I still get doctor bills now 2 months out from doctors I've never even heard of. I've actually called them to ask what they did for me. Just remember slow deep breaths. Keep saying that over and over every time you come back from the mailbox with an armload full of Doctor and hospital bills.
  • Just a quick comment to you here. Since you have an attorney, he probably has told you that YOUR auto insurance also pays medical expenses. This is probably the only instance of collecting double, but it is perfectly legal. You just make a claim on your auto policy for medical charges. This will put money in your pocket quicker than waiting on litigation.
  • I was in an auto accident several years ago (I rear-ended a semi-truck ... my fault) and needed surgery to reattach a ligament in my thumb and another procedure for my shoulder.

    My auto insurance covered whatever my medical insurance did not for the thumb surgery. For the shoulder surgery, we had changed medical insurance due to a job change and the new medical insurance did not cover anything from auto accidents. My car insurance ended covering 100% of the shoulder surgery. All I had to do was show them proof of the insurance change and provide them with the new policy that did not cover auto accidents.

    My auto insurance even paid roundtrip mileage for doctor appts, PT appts, surgery, tests, etc.
  • I sold auto/homeowner's insurance for about 8 years...although quite a few years ago.
  • or you guys could be as "lucky" as me and be billed for the remainder of money AFTER the discounted/agreed price... ya, talk about MAD! I hate insurance companies!!!! But then again, I would've had to pay A LOT more if I didn't have insurance, huh... ugh... double-edge sword!
  • Mine was just over 300k for a 2 level fusion with instrumentation! I had the chief of Orthopedics and a Neurosurgeon. But in a city were a parking spot can cost 200k and a tiny 1 bedroom apt. goes for 1M, no price would have surprised me. I get sticker shock every time I walk out of my apartment! :O
  • I only had liability since my car was older and paid for. My attorney keeps telling me to send him the bills and not to worry about it. But I keep telling him it's not him they're calling it's me. He is sending them all letters of our intent to file suit against the semi driver since he was cited for an improper lane change. But in the meantime I continue to pay my copays which is killing me since it seems I have a doctor's visit once a week at least. Oh how I wish I had put collision on this car. But hindsight being what it is...... But my medical is paying for now and I have given them my attorney's information so that they can be reimbursed. I'm trying to play fair but if my insurance company keeps treating me the way they are the way I feel about it is, "Come find me when this is over." I've tried my best to help them out and explain over and over that they're going to get their money back just pay the stinking claim! To this day they refuse to pay the ambulance bill because the Metro Fire and Rescue is "Out of Network." You should have heard the conversation I had with them over that one. I guess they expected me to crawl over to my car which was laying sideways try to find the bits and pieces of my purse and call them to see which ambulance company should pick me up since i was laying there BLEEDING! It's all kind of comical now but I was really mad in the beginning.
  • nycgirl said:
    Mine was just over 300k for a 2 level fusion with instrumentation! I had the chief of Orthopedics and a Neurosurgeon. But in a city were a parking spot can cost 200k and a tiny 1 bedroom apt. goes for 1M, no price would have surprised me. I get sticker shock every time I walk out of my apartment! :O
    From your "name" I assume you live in NYC..I am on the island but my surgery was done in the city. I also had chief and neurosurgeon..for a one level cervical with instrumentation. I didn't see my bill since it was workers comp..now I am very curious!!
  • I just got my EOB from the insurance company for the actual surgery (not including hospital stay or surgeon's fees). The hospital billed $50,000 which seems low compared to some of the other people here. :))( The insurance company is paying the hospital about $8k and my share is about $500. My surgery lasted about 3.5 hours. I wonder if mine is cheaper because my surgeon didn't use BMP. I know he had told me that he didn't like it because of the overgrowth problems and that it was very expensive. Instead he used blood with bone marrow from my hip with the bone from my spine. My surgery was also minimally invasive.
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