How much does artificial disc replacement cost?

[Harrison]

Simple question, but a complex answer!

Here’s an excerpt from an archived message on the costs of ADR in the U.S.

Costs of ADR?! Hah! What a messy issue that is! Here's my 2 cents after rigorous (OK, just a few hours) of research on a 1 level:

Average price across all U.S. states: $32k
Median price across all U.S. states: $45K
Extreme price range across all U.S. states: $10-$80k

And some helpful topics on this issue….

I Need The Total Disc Replacement Cost-USA
http://adrsupport.org/eve/forums/a/tpc/f/7701036081/m/6...101098412#8101098412 (http://adrsupport.org/eve/forums/a/tpc/f/7701036081/m/6831035412?r=8101098412#8101098412)

ADR COST?
http://adrsupport.org/eve/forums/a/tpc/f/7701036081/m/7...651032902#6651032902 (http://adrsupport.org/eve/forums/a/tpc/f/7701036081/m/7671068081?r=6651032902#6651032902)

Which ADR Clinical Trials Are No Cost to the Patient?
http://adrsupport.org/eve/forums/a/tpc/f/7701036081/m/8...991018081#8991018081 (http://adrsupport.org/eve/forums/a/tpc/f/7701036081/m/8991018081?r=8991018081#8991018081)

cost of adr Germany
http://adrsupport.org/eve/forums/a/tpc/f/7701036081/m/6...251018081#6251018081 (http://adrsupport.org/eve/forums/a/tpc/f/7701036081/m/6251018081?r=6251018081#6251018081)

And also:
http://adrsupport.org/eve/forums?m=1691056081&a=tpc&f=7701036081

[wgnmn]

November 17 , 2010 I went to England and the total cost of surgery and Hospital was 40 k for my 3 level m6 c replacement. Lodging ,air fair, rental car were added to that. Of course that is US currency and the exchange rate just keeps getting worse.

[Jstuckey]

1 week hospital stay and 2 weeks of outpatient therapy afterward, all medical costs included (but not flight, housing) for 2 level M6 and STALIF fusion in England with Nick Boeree is quoted at 23,168 pounds (current US dollar exchange rate= $37K). Hoping the pounds drops in value by September! (Sorry Brits!) I can stay longer in the hospital if needed, for no extra fees. Any complications are covered, unless a specialty surgeon not on staff has to be called in.
Germany (Bertagnoli) was almost twice that, but included the hotel. (I found a house to rent in England for about $1500 for a month, so not seeing the value of tacking that on to the surgery cost)
Spain (Clavel) was comparable to England, slightly more.

Keep in mind you'll likely get kicked out of the hospital much sooner in the US. If you did need to stay longer, count on mulitplying any cost estimates considerably.

Check that even if your insurance doesn't cover the ADR itself, will they cover the therapy, anesthesia, any other parts of the surgery process or hospitalization? Therapy is very expensive (I'm a therapist), as is the general care in a hospital. Make sure all of the costs are accounted for.

[JEVE19]

I'm going on Aug 4th to have a pro disc put in my L5 by Dr. Zigler

My Cash price:
$40,550

$19,000 for Dr Zigler and general surgeon assistant
$21,550 for one day hospital stay

That's my "cash discount"..LOL

[silversurfer]

Just got quoted 34000Eur for two level replacement with Dr. Bertagnoli. Includes 5 days in the hotel room. Seems like costs are rising!

[Jstuckey]

I ended up paying about $32,000 (US dollars) or 20,000 British Pounds for my 2 level hybrid (originally quoted and paid for a 3 level, and recieved a refund without a problem). (See details in above post and below in my signature). No travel expenses included, and that included all care for the surgery, 6 days in the hospital (could have stayed longer at no charge) and all post op therapy, meds.

[SpineInSecurity]

I had a C5-6 ADR with a Prodisc-C last month in Charlotte, NC.

Total cost billed to my insurance (UHC) was $62,000. The device itself was an $18,000 line item on the itemized bill.

I had already met my annual out-of-pocket max, so UHC paid this 100%. (Gotta love their decision on October 1, 2011 to cover cervical ADR!)

[Cheryl0331]

will insurance pay anything when you go out of country?

[Jstuckey]

Mine wouldn't. Some (rarely) do though...

[Spine Journey]

will insurance pay anything when you go out of country?

I have Aetna, live in the US and considered going to England for my ADR.
Aetna informed me that if you live in the US they will not cover ADR if you choose to travel abroad for your ADR surgery. Typically, the Aetna policy will cover "emergency surgery needs" that occur ONLY while you're traveling abroad.

[laid up doc]

Cheryl,

it depends on your policy... a few people have gotten overseas surgery covered, but they are definitely in the minority.

i also have an Aetna policy that will cover 1 level US ADR, but nothing overseas, and not 2 level ADR nor fusion for DDD (2 level and fusion addressed in their policy statements - pretty sure that applies to ALL Aetna policies).

[RedheadJules]

My quotes so far for 3 Level Cervical ADR:

$75-85,000 Dr. Lauryssen at Olympia Medical Center Beverly Hills, CA
(2 day hospital stay)
€36,408 for Dr. Bertagnoli, Straubing, Germany
(5 day hospital stay, plus companion and single room supplement)

Awaiting Dr. Clavel, but so far was given a €33,000 estimate which includes much more than both above and everything except meals outside of hospital and airfare.

[M1013828]

50k in NZ for an A-Mav at L4-L5 level and a fusion cage with bone morphogenic protein at L5-S1. (with one of the countries leading neurosurgeon)
I got a shock because a double fusion with an Ortho was 18k, expected 25-30k.

[dooggie]

Hi guys Richard here i was qouted $8,900 through a Medical tourist advisor www.placidway.com (http://www.placidway.com) for a single level L5-S1 artificial disc replacement in India. Spinal kinetics M6 Lumbar procedure .If your having a hard time trying to find the funds to go to germany like i am, contact placidway .The dr in india is trained in germany and the us.Airfair and hotel, meals after the hospital stay are extra but for under $11,000 US your done and back to a normal lifestyle.

Just thought i would pass this on.I have the contact information for the dr and hospital in india as well as the drs resume. The hospital is a private hospital and state of the art .Oh and they can do surgery with one weeks notice.Yah one week at least that is what i was told.I would have been on the plane allready but i cant get a loan for $11,000 either!Anybody want to help me with the funding!Good luck!

[dooggie]

I would love to say yes but i have no money to go may as well be 11 million dollars i am no closer to going.I am having to sue my car insurer because they are refusing to pay for it.Having to live on half as much money as i was when i was working forced me into bankruptcy pretty quick so no chance at getting a loan.I am in Canada and you cannot see a spine surgeon unless a dr gives a referal to one.I finally got the referal from a pain mangement drug pushing specialist i was seeing when i told him i wouldnt leave his office till he actually looked at my MRI cds I brought with me.He took one look at my back MRI and said BOOM!I will make the apiontment know.That was Thursday .But that takes from a year to 2 years to get the first appiontment and another year to schedule the surgery.Its considered elective in Canada.My only saving grace is i have my first court date in december.If they appeal it could take another 2 years before i get any money.If i have the surgery in Canada i am at the mercy of what ever surgeon i get to decide what surgery i have.There are only 6 spine surgeons in my province that do ADR surgery. 2 of them are 30 minutes from my house they may as well be 10,000 miles away.My lawyer agreed that i have a tort claim agianst the city i had the car accident in finally Supreme court decided citys are responsible to maintain roads no excuses.So i will be rich someday just have to wait 10 years to get it through the court system . So i am in hurry up and wait mode .Its a race against time for me i do not walk with out a cane anymore and the numbness in my legs gets worse all the time.Wheelchair or surgery what ever comes first. Lifes a bitch!

[Karger]

Due to the rising cost of the EURO it may vary.

Here is what i paid.

Hired the best of the best surgeons = 8500 Euro.
5 star Klinik Cost = 19500.00 EURO

Convert that to Canadian when the euro was 1.50 or very close, I can't recall, it was 42k Canadian.

Hope that helps.

[Karger]

also, that was just 1 level adr. l5 s1 activ-l disc.

i went into alot of debt and probably never retire, but worth every pennie

[Optimistic]

While Doogie posted an interesting alternative to the European solutions, I suspect that most members who choose ADR select their surgeon very carefully. It is not simply the M6 product or the Activ-L, the experience of the surgeon must be a significant selection criteria. While Doogie did post in 2012, I would be curious whether the Indian surgeon has the experience of the European surgeons. After all, the European surgeons focus on ADR and possibly hybrid surgeries almost exclusively. They spend time with patients on initial consults, surgical procedures, follow-up and in some cases, presenting at conferences and performing research. This dedicated focus is certainly worth the investment in a procedure that most of us want to experience only once.

[Kelly4ADR]

I just received a quote from Clavel in Barcelona for a two level cervical with the M6 ... 29,790.00 €.

I don't know what the exchange rate is.

[Karger]

While Doogie posted an interesting alternative to the European solutions, I suspect that most members who choose ADR select their surgeon very carefully. It is not simply the M6 product or the Activ-L, the experience of the surgeon must be a significant selection criteria. While Doogie did post in 2012, I would be curious whether the Indian surgeon has the experience of the European surgeons. After all, the European surgeons focus on ADR and possibly hybrid surgeries almost exclusively. They spend time with patients on initial consults, surgical procedures, follow-up and in some cases, presenting at conferences and performing research. This dedicated focus is certainly worth the investment in a procedure that most of us want to experience only once.

I agree. I picked my surgeon and not my disc. I wanted to find the best surgeon for myself and have them do a perfect diagnosis. Once done, which ever disc they wanted to put in me, I would go with. They are the expert, not me :)

[Jen93312]

As of today, 1.36 U.S. dollars = 1 Euro. It seems to always be higher in the summer months (peak season).
I don’t really agree with picking the “right surgeon” as your only criteria. For instance, there are great surgeons in the U.S., but they only have access to certain implants. I think what tools they have is critical. Just my two cents.

[Karger]

If you pick the wrong surgeon who puts in the wrong disc or doesn't do correct Placement then your going to be still in pain and out a lot of money. I decided to go to Germany since surgeons have been doing adr since 1990 and only 2008 for Canadian and US.

So I have to disagree with your statement because you do need a skilled surgeon who knows what they are doing or you will be doomed to fail.

Picking your your surgeon based on the adr is a bad idea. If I would have went with the m6 it would have failed because of my spine pathology. I'd be out 40k and still in pain

[drewrad]

$50K US not including travel and extra stay.

I followed God. He directed me specifically to Barcelona through so much confirmation it got to be absolutely bizarre. Can't get into it here but it was pretty intense.

I'm glad I followed God. He knew better than I did.

The bone density I took in the States was improperly performed. The DEXA Clavel ordered here was much more precise and showed an entirely different result. Who knew? God.

We therefore went M6. And to boot, my vertebrae were perfectly sized for large M6 end plates as if they were modeled for them. You'll see when I show pics later. It's unreal.

Beyond that, again, God, God and more God. So much God here in this. I woke up screaming 'Jesus Cristo es mi luz y mi salvacion' in the reanimacion room with all the others. Not sure if I was hallucinating. They had to wheel me out of there apparently because I was getting louder and louder.

Even Clavel said to me after, 'God was in the room with him and the surgery was perfect, perfect, perfect'. His words.

Had many people praying for me.

[henry4956]

I was 45k, the difference between the European top guys is minimal. You start at approx. 40K for 1 1evel and add about 4k for each additional level. Karger was 1, I was 2 level and I think Drew was 3.

To Karger, I hear you and agree, but most folks on this forum will tell you that you are barking up the wrong tree (they could change the name of this to M6support.org. I commend you on making the right choice (Zeegers/ActivL) for you .

To Drew, I am so happy that you found the right solution with Dr Clavel and the M6L, truly. I was one of your prayer warriors and I know of no one who has put more time and effort into the vetting process than you. More importantly, it's nice to see someone rely on God for direction (how can you go wrong with the creator of the universe directing your path) But hey man are you speaking in tongues now?

[scoop302]

A 2 level fusion in Fl. would be anywhere from about $85 to $120k. Because my bad disc's are from an auto accident, the other party has to be sued, all the doc's work under a letter of protection and once my attorney is done, he negotiates settlements with each party, so cost is up in the air. Dr Bierstedt was 30,000 euro all in except flight, Dr Clavel is 29,790, no hotel or transport. I have not got a quote for VIP services, which would include these, I guess. I know it would cost more to do it here, plus it would be 2 fusions, which would then be 3 in a row. I am 100% certain that would lead to future problems above and below. If I pay for this, while not a guarantee, I feel confident that I will be afforded a better quality of life with the ADR's. I firmly believe that the first fusion restricted my range of movement and set me up for where I am now. I guess the upside is, with the auto insurance I may get my money back, but it is not guaranteed. I will update on VIP services when I find out.

[Optimistic]

While I explored the options with surgeons & procedures, I did deal with a Florida group who specializes in Minimally Invasive surgery & cervical ADR. It is called Center for Artificial Disc Replacement. I was looking for a 3-level lumbar ADR and based on my spondy, they proposed a 2-level ADR and 1-level fusion. They passed it through my insurance carrier and it was denied. They then provided a quote for self-pay which came out to $82K US.

While it was interesting to obtain the quote, the surgeons do not have experience with lumbar ADR. I find the quote to not be unreasonable for the work. However, with the Prodisc option proposed, the lack of lumbar ADR experience, only 3 days of hospital stay, potential for extra costs associated with longer stay, additional follow up, etc., it was not very appealing.

In my opinion, the skilled European surgeons, better ADR products used, more experience with placement, complications, etc. and significantly better price offer a better overall solution. While costs that are covered in this posting demonstrate that Europe is a better choice, it is never the costs alone that are encouraging so many people to travel for surgery. It is often when a procedure will be covered by insurance do people select a US surgeon.

Henry, I don't agree that the forum is an M6 support forum. As Drew and others can attest to the investigation of Activ-L and M6, the support is to members for everything from investigating options, surgery or other, to selection of surgeons, questions to ask, bone density, recovering members with or without complications, etc. I am very pleased that you used a great surgeon and had a successful procedure. While we are both still in recovery, I hope ours will ultimately be a full recovery with no pain and regaining all of our functioning to become once again very active individuals.

[atxmom]

For cervical ADR, the estimated cash price I was given was (Dallas, Tx)
1 level - $22,000
2 level - $29,000
3 level - $36,000

This only includes main surgeon, anesthesia, hospital stay, disc device, facility, and monitoring (does not include assistant surgeon, x-rays, pathology, internist or complications, if needed)

[Throttlejockey]

atxmom,

What device did the folks in Dallas quote? Did they give you an estimate of what the other items that were not in the quote might cost?

Thanks,

Dave

[Kelly4ADR]

Two level cervical...48k in Washington State. That includes 2 implants at 7.5k each. If paid in full at the time of service- 40% discount (not on the implants) so that brings it just under $35k.

[drewrad]

Two level cervical...48k in Washington State. That includes 2 implants at 7.5k each. If paid in full at the time of service- 40% discount (not on the implants) so that brings it just under $35k.

Curious if you know what a two level lumbar would cost?

[Kelly4ADR]

Curious if you know what a two level lumbar would cost?

Drew,

I don't know. I can ask them.

[colorado babe]

I have just started to get some of the bills from my surgery here in the states. It isn't cheap. I do remember when I got a quote from Dr. Ritter-Lang for three disc it was 80K. So I would say in Europe about $27,000 per disc which includes everything.

[Romakis]

I just got a quote for a total of $48,000 for the L4-S1 M6 ADR.

[Cheryl0331]

Quoted 29,500 euros which is 32,100 USD depending on the exch. rate

[Cynlite]

Cheryl ~

What are you having done by Dr. Clavel for that price? Thx.

[JeffR]

I have just started to get some of the bills from my surgery here in the states. It isn't cheap. I do remember when I got a quote from Dr. Ritter-Lang for three disc it was 80K. So I would say in Europe about $27,000 per disc which includes everything.
The quote shouldn't be the same cost per disc since there is a fixed-fee cost element for the procedure, i.e. the hospital stay is the same length no matter how many discs you get and certain operating room elements are the same no matter what. The cost should then go up by disc, i.e. each disc costs $X + and you are in the OR longer per disc which cost $Y per disc say.

[Harrison]

Perhaps this pricing is similar to US doctors too. Check the higher volume clinics.

[Carwyn]

I used to be able to go private (£180 per consulation) then go between NHS (free) and private as it suited. Mri scan under anesthetic was £900, bone scan £400 etc etc

This has now been stopped in the UK.

Initially I was quoted £30,000 for my two level ADR, I was seriously thinking of putting the house up for sale and then after pushing the PCT

NHS Trusts and Primary Care Trusts - information - Grace Care (http://www.grace-care.co.uk/helpful-information/care-directory/nhs.php)

and proved I was in the area covered they agreed the operation could be done on the NHS (free)

Looking once more how to proceed as I am back almost to square one.

Carwyn

[Cynlite]

Please see post 91 on my thread. I contacted a bunch of members and put together a spreadsheet on costs for ADR surgery in Europe and the US. Hope this helps others to plan for surgery.

FYI - In the US, the Mobi-C manufacturer is helping people to fight for insurance coverage if you use their disc.

http://www.adrsupport.org/forums/f63/germany-dr-bierstedt-cervical-adr-13049/index10.html

[Jerry5]

The Cost is probably about 30K US, for one level, and the second, maybe another 7500, so if the indications are there, for two level, (like I had) go for it.

As with all surgeries, especially the lower two lumbar, there will be distraction issues afterward, and some maybe permanent, some of the damage may have already been done.

FYI

[Cheryl0331]

Don't pick your doctor based on price. Two Germany surgeons gave me way lower costs than did Clavel, but I went with Dr. Clavel because his assessment was the most accurate and complete.
I would have most likely needed another surgery within a year or so if I had gone another direction.
Remember Dr. Clavel is in high demand for a reason. He and his staff, his hospital are worth the wait. While right now is a busy with others someday that will be you he is busy for while someone else waits in turn behind you. When you're in a doctors office you want them to spend time with you but yet you get impatient while waiting to be called back. If I needed any other spine surgery; I would not hesitate to go back to Dr. Clavel. Do you homework and make an informed choice. Be well and God bless.

[cfbugsbunny]

Dr. Clavel was anywhere between 30-40K depending on exchange rate and what's being done. I unfortunately needed surgery when rate was high. Now it is significantly cheaper. This rate includes the PT, hotel stay before and after and any testing / followup visits during your stay. The only extra I needed to cover was my plane flight and meals and misc expenses. I personally thought this to be extremely cheap.

[Cheryl0331]

I paid $32K USD for my two level M6-C - my guess it at least $27K for one level.

[Harrison]

Hey everyone,

It's been years since I've collected, analyzed and lamented about pricing for spinal disc replacement. Here's "stage 1" of this rather perfunctory project. It's a document I put together just now.

Some good news for BCBS subscribers in five states -- 2 level cervical ADR is covered. Lumbar is still almost twice the cost of cervical -- no changes there. Which is nutty.

See PDF attached.

[Cynlite]

Great info Harrison and thanks for gathering that data for everyone!

TBI still leads the charge in the U.S. as expected. They have some of the best surgeons with the most experience in the U.S. and best prices IMO for ADR. The three level cost for cervical is pretty comparable to Europe. The difference with Dr. Clavel is that he includes physical therapy plus, two nights in a first class hospital, one week hotel is covered, plus one year health insurance on the surgery. My care was more concierge and I was watched for three weeks. The insurance is specific to the surgery not new disc levels and requires one to go back to Spain at their own cost to the same surgeon who did the surgery if there is a complication. So, it's hard to do an apples to apples comparison but, they are pretty darn close. If a person's insurance covers them in the U.S. then the surgery would certainly be less expensive. I think a three level Mobi-C in the U.S. would be less than a 3 level M6-C in the end in Spain without all the other things I mentioned at TBI. All the other surgeons and hospitals in the U.S. are all over the place on what they charge. Then the question comes down to the disc. There are lots of opinions out there about what is the best disc. I've learned my lesson to stay out of that debate here.

The last piece of the puzzle is does a person leave their state or country to get surgery? IMO, the surgeon makes all the difference to the outcome. If you leave your state or country, you are somewhat locked into going back to the same surgeon if things don't go well for you but, not always. There are surgeons in many cities that will be happy to remove an ADR and fuse. That would not be my choice but, it is still an option. If staying in the U.S., I still agree that TBI is one of the best options with the best probability of a good outcome. It's not as big a deal to travel back to them if there are complications. The odds of complications are less with them too IMO compared to other U.S. surgeons. My opinions are all subjective of course. Also, can they do a three level ADR in one surgery in the U.S.? I thought we were limited to a two level Mobi-C for cervical.

There is one surgeon in New York that has caught my attention for cervical patients but, I'll wait until I have more info. to share on him.

[bigsky]

I am a 3-level cervical ADR candidate, as evaluated by US and overseas surgeons. Was told only one level ADR could be done at TBI, and 2 levels fused. Glad to hear 2 levels now approved. I, too, am interested to know if anyone does (or is allowed to do) 3 level ADR. I would appreciate hearing from other 3-level post-op patients with a private message. Thanks so much!

[Cynlite]

I just checked the manufacturer's website and the FDA publication for the Mobi-C. Both still say it's approved for a two level ADR. Not sure how TBI is doing a three level cervical ADR in the United States.

http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm367809.htm

http://www.cervicaldisc.com/

BigSky, I stopped private messaging because there were just too many messages and it got too much for me trying to keep up with all of them while I'm healing post surgery. There are not many of us three level cervical patients on this Board. Phillyjoe and I are the most recent. The others were quite a few years ago. I've written everything I know in my threads so, hopefully the information there will help you. I got much of my information by contacting the surgeon's offices directly and reading the post surgery forum.

[RiverMiles]

Hey everyone,

It's been years since I've collected, analyzed and lamented about pricing for spinal disc replacement. Here's "stage 1" of this rather perfunctory project. It's a document I put together just now.

Some good news for BCBS subscribers in five states -- 2 level cervical ADR is covered. Lumbar is still almost twice the cost of cervical -- no changes there. Which is nutty.

See PDF attached.

Hey Harrison - Great info.
Do you know if the information on the attachment takes into account Aetna's scheduled policy review for intervertebral disc prostheses? http://www.aetna.com/cpb/medical/data/500_599/0591.html

It was scheduled for July 8 but policy reviews have between running behind this year. I was told that the review has not been completed yet and the website shows no update as of yet. But, the attachment says, "as of July," and it's TBI so they may well have intel of a policy change, or a policy not changed, before it has been announced.
Thanks again for this pricing and coverage info.