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#31
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Drewrad: $50,000, 3 level hybrid, L3/4/5 M6L, L5/S1 fusion. Clavel.
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Weightlifter since 12 years old, now mid-40's and figuring out this wasn't such a good idea. Chronic back pain started in 2010 while shrugging weights that a 40 yr. old shouldn't even try. MRI in 2012 showing L4/L5, L5/S1 herniations and L2/L3 bulge. L5/S1 taking on new shape, chronic sciatica, etc. DEXA bone scan performed 5/7/14 showing mild osteopenia. Surgery performed July 9th, 2014, Dr Clavel, hybrid three level lumbar. |
#32
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Colorado Babe's surgery cost was ~132K not ~26K. The ~26K was just the amount that insurance covered.
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Lifelong history of back issues from a young age, spasms etc. 1995 - Weightlifting injury 1997 - Hip Injury 2009 - Trampoline injury (just bounced down on my butt) 2009-2011 Physiotherapy and medication, progress but no lasting pain relief 2010 - X-Ray DDD L5-S1, L4-L5, L4-L3 2010 - MRI Herniation L5-S1, Bulges L4-L5, L4-L3 2011 - Epidurals - No relief 2012 - Facet Injections - No relief 2012 - Discogram TBI - positive L3-S1 L3-S1 ADR M6-L w Clavel 11/28/2012 |
#33
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JeffR re insurance
My understanding is that the hospitals charge an inflated amount knowing what is the allowable amount. They then write off the difference as a loss. Colorado Babe did not have to pay the difference so, the inflated amount is just air for tax purposes the way I see it. If I'm wrong, I'm happy to make the changes on my spreadsheet but, I'll leave it the way it is for now. Thanks for your input on this Jeff. I appreciate everyone's input. I'm doing this exercise to help others so they don't have to look so hard to find the data we all worked hard to get.
Thanks drewrad. I've added your information!
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2006: epidural shots did nothing; 2 surgeons recommended 2 level fusion, I declined. 2007 - 2010 4 foraminotomy and cord decompression cervical surgeries and 2 endoscopic discectomy T7-T8 surgeries; total 6 with Dr. Jho (Pittsburgh,PA) My C6/C7 autofused around 2009. 2013 - 2015: epidurals 3 times (again did nothing) and 4 Radiofrequency ablation (or RFA) procedures. 2016 more RFAs, hit the 10 year mark of this insanity and pain, 3 level M6-C ADR with Dr. Clavel May 19, 2016 Last edited by Cynlite; 04-13-2015 at 11:49 PM. |
#34
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Honestly a hybrid procedure out of pocket is definitely over 100K in the US. I was quoted 125K for a hybrid with two prodiscs from TBI and they tried hard to get the price down - and that was 3 1/2 years ago.
The amount insurance covers is NOT what colorado babe ended up having to pay, i.e. if insurance covered 26K and the procedure was 132K then she had to pay 106K out of pocket. Putting the price down as 26K on your sheet is misleading since no one is going to pay that amount for that procedure even with insurance (it is just what the insurance company was willing to cover).
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Lifelong history of back issues from a young age, spasms etc. 1995 - Weightlifting injury 1997 - Hip Injury 2009 - Trampoline injury (just bounced down on my butt) 2009-2011 Physiotherapy and medication, progress but no lasting pain relief 2010 - X-Ray DDD L5-S1, L4-L5, L4-L3 2010 - MRI Herniation L5-S1, Bulges L4-L5, L4-L3 2011 - Epidurals - No relief 2012 - Facet Injections - No relief 2012 - Discogram TBI - positive L3-S1 L3-S1 ADR M6-L w Clavel 11/28/2012 |
#35
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Jeff, I sent Colorado Babe a message to see if she can clear this up for us.
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2006: epidural shots did nothing; 2 surgeons recommended 2 level fusion, I declined. 2007 - 2010 4 foraminotomy and cord decompression cervical surgeries and 2 endoscopic discectomy T7-T8 surgeries; total 6 with Dr. Jho (Pittsburgh,PA) My C6/C7 autofused around 2009. 2013 - 2015: epidurals 3 times (again did nothing) and 4 Radiofrequency ablation (or RFA) procedures. 2016 more RFAs, hit the 10 year mark of this insanity and pain, 3 level M6-C ADR with Dr. Clavel May 19, 2016 |
#36
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I had a two level Mobi C at cervical and a fusion at L5-S1!
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1998- Injured neck and back in USAF 2011 - Started experiencing Severe Symptoms, Migranes, numbness, spasms in legs and feet and sciatica. Feb 2014 - Received upper Lumbar Injection - Severe Allergy to injection Mar 2014 - MRI of Cervical and Lumbar, protruding disc in C3-7, Herniated Disc in L5/S1, placed on STD and FMLA ) July 2014 - Stem Cell Procedure performed Oct 20, 2014 - ADR (MOBI-C) at C5-7 and Anterior Fusion at L5/S1 by Dr. Pettine and Dr. Techy |
#37
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Quote:
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1998- Injured neck and back in USAF 2011 - Started experiencing Severe Symptoms, Migranes, numbness, spasms in legs and feet and sciatica. Feb 2014 - Received upper Lumbar Injection - Severe Allergy to injection Mar 2014 - MRI of Cervical and Lumbar, protruding disc in C3-7, Herniated Disc in L5/S1, placed on STD and FMLA ) July 2014 - Stem Cell Procedure performed Oct 20, 2014 - ADR (MOBI-C) at C5-7 and Anterior Fusion at L5/S1 by Dr. Pettine and Dr. Techy |
#38
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$25.00 is pretty cheap. :P
Is the $25K what YOU paid our of pocket (and insurance paid the rest), or what the insurance company paid on your behalf (and it cost you nothing)? You said earlier it was the amount paid by insurance which is why I was/am confused...
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Lifelong history of back issues from a young age, spasms etc. 1995 - Weightlifting injury 1997 - Hip Injury 2009 - Trampoline injury (just bounced down on my butt) 2009-2011 Physiotherapy and medication, progress but no lasting pain relief 2010 - X-Ray DDD L5-S1, L4-L5, L4-L3 2010 - MRI Herniation L5-S1, Bulges L4-L5, L4-L3 2011 - Epidurals - No relief 2012 - Facet Injections - No relief 2012 - Discogram TBI - positive L3-S1 L3-S1 ADR M6-L w Clavel 11/28/2012 |
#39
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ADR Costs I have so far
Thanks for the updates. Hopefully, I have all the information correct now but, if I don't please let me know. I updated the information in all places I put the spreadsheet so people don't run across older copies and rely on that information.
BTW, Colorado Babe, I think you are winning the price war on cervical disc replacements. You just beat out our lowest European price. It's really good information to know that your hospital and Top Doc accepted that amount in the U.S.! I think that the amount "allowable" was determined by Medicare but, it could have been a negotiated rate by your insurance company. I'm not sure every hospital and doctor would accept that amount since it's a negotiated price but, still really good leverage. My insurance will not cover me out of state because it's a Medicare HMO (I'm on disability) so, I think an appeal would most likely be useless since this restriction is stated up front. I am only covered out of state if it's an emergency. However, I may give Dr. Pettine's office a call when all is said and done. Now, my big question will be is it worth paying the extra money going to Europe to get the M6-C?
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2006: epidural shots did nothing; 2 surgeons recommended 2 level fusion, I declined. 2007 - 2010 4 foraminotomy and cord decompression cervical surgeries and 2 endoscopic discectomy T7-T8 surgeries; total 6 with Dr. Jho (Pittsburgh,PA) My C6/C7 autofused around 2009. 2013 - 2015: epidurals 3 times (again did nothing) and 4 Radiofrequency ablation (or RFA) procedures. 2016 more RFAs, hit the 10 year mark of this insanity and pain, 3 level M6-C ADR with Dr. Clavel May 19, 2016 |
#40
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Insurance paid it Jeff. My share was $25.00. Not sure why you are confused.
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1998- Injured neck and back in USAF 2011 - Started experiencing Severe Symptoms, Migranes, numbness, spasms in legs and feet and sciatica. Feb 2014 - Received upper Lumbar Injection - Severe Allergy to injection Mar 2014 - MRI of Cervical and Lumbar, protruding disc in C3-7, Herniated Disc in L5/S1, placed on STD and FMLA ) July 2014 - Stem Cell Procedure performed Oct 20, 2014 - ADR (MOBI-C) at C5-7 and Anterior Fusion at L5/S1 by Dr. Pettine and Dr. Techy |
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