Single level ADR Cost in U.S.

[Fred_2010]

Assuming one did pay for a cervical ADR procedure out of pocket in the U.S., what should one expect to pay (all costs included)?

I received one decline from Cigna on pre-certification. I also have insurance through BCBS, and will try my luck with them.

Thanks

Fred

[Harrison]

Fred, did you already see this FAQ topic? Please note that this forum is six years old, so this issue involves topics going back years, so take this into consideration when assessing the cost trending.

ADR Pricing

http://www.adrsupport.org/forums/f49...ent-cost-5167/

Also, I did get your PM about insurance in Nebraska; I am not tracking that information and don't know who is -- sorry.

[Fred_2010]

Single level ADR was denied by both Cigna and Blue Cross Blue Shield due to the procedure being considered "investigational". The total cost to pay out of pocket was quoted at approximately $48,000 for C6/C7 disk replacement, which I can not afford to pay. I am having constant headaches and numbsness of my scalp in addition to stabbing shoulder pain in my shoulder and numbness in my fingers. I can not tolerate a lengthy appeal, and will take the best alternative that insurance will pay for.

[CharlesinCharge]

I am not sure if you are willing to go overseas to have the surgery done, but I know you can go to India or Spain and get a single level cervical ADR done for less than $20,000 (and that includes everything---hotel, flight, incidentals, etc.). There are people on this board that have done it, you can get details from them. Not sure if you have that much money or if you are amenable to going out of the country, but your only other option will be fusion, because that is all most insurance companies will pay for here in the U.S.

[Harrison]

Fred, you already know this, but fusion is not a "bad" procedure to have if you are boxed in by your insurance company. And this would be covered by most major insurance providers. Plenty of folks in this community have had cervical fusions.

[Fred_2010]

Harrison,

After being initially frustrated and angry, I feel better about the fusion procedure. The serious disc rupture, stenosis and spurring is at C6/C7, but I also have a bad disc at C5/C6. The doctor proposed single level ADR because that is all that is approved by the FDA. However, it is possible that I would have also needed ADR of C5/C6 down the road.

Now, the doctor is going to fuse C5, C6 and C7, and hopefully most of my problems will be solved. I view the fusion procedure in my case to be reasonable, but I do think that Americans should be afforded the same access to single and multi-level ADR that is available in Europe without insurance companies or government bureaucrats making the decision for us. I mean there is some successful track record for these procedures in Germany and other countries, so for the insurance companies to claim ADR is investigational is bogus in my opinion.

I am okay with fusion and look forward to getting this over with (on July 13th). I will provide an update after the procedure, but from what others have told me I expect immediate relief.

Thanks.

Fred