Hello all. I'm a 39 year old patient at the Texas Back Institute, and I have 2-level herniations from L4 to S1. My insurance has agreed to pay for a single Prodisc replacement, but won't pay for a 2-level or a fusion hybrid. The cost to add the 2nd disc is $17.5k (7.5k for doctors, 10k for the disc). That's a pretty steep amount for me right now. Do I:
- Beg, borrow and steal to come up with the money and have the 2-level ADR?
- Have a 1-level ADR since I can afford that, and have the 2nd done in a future operation?
- Wait until a clinical study is done for 2-level ADR and try to get in? (this is looking like it will be a year or 2 out, minimum)
- Or pay for a hybrid? (don't know what the OOP would be, but I'm not too excited about the fusion aspects)
: My insurance carrier might change next year due to some things happening at work, so I don't know if I'll still have a "disk friendly" carrier in the future.
Lastly, I'm curious to know what other's experiences are with trying to negotiate prices. Moreso I'm interested in negotiating a lower price on the disk itself, as I know there is markup and sales rep commissions involved potentially, so should be some wiggle room, but so far contacting Synthes lead me nowhere, and in my case my doctor isn't the interface with the sales rep, it's the hospital instead, but haven't yet tried to negotiate with them, wanted to hear your advice first. Thanks!