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Insurance Hell All insurance-related matters are here: Medicare, worker's compensation, appeals, denials, insights, wins, losses. PRICING is here too. Note: This forum has posts from 2006 forward. Older ones are in the Big File.


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  #1  
Old 05-18-2009, 06:38 PM
Jdouglas Jdouglas is offline
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Join Date: May 2009
Posts: 33
Default ADR - Cost. Going it alone?

Does anyone have any idea of what artificial disk surgery actually costs in the USA? I am waiting for my surgeon to give me an idea of this and was curious if anyone on the site paid out of pocket to have it done domestically and what the total was (including hospital cost)? Seeing as though United Healthcare has rejected my appeal, I am considering figuring out a way to finance the surgery or something. Just trying to weigh options. Thanks for any help.

-----------------------------------------------------------------------------
L5S1 Herniation and Annular tear
Over 10 epidurals,
DDD, 2 discograms (positive),
Countless attempts at conservative therapy.
Tentative Surgery date 5-26-09 (very much in jeopardy!)
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  #2  
Old 05-18-2009, 07:33 PM
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Harrison Harrison is offline
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Join Date: Oct 2004
Posts: 7,010
Default This FAQ may get you started...

How much does artificial disc replacement cost?

Hope this helps. For other folks that have recently paid out of pocket for US surgery, how much did you pay?
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Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
Donate www.arthropatient.org/about/donate
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  #3  
Old 05-18-2009, 07:53 PM
Jdouglas Jdouglas is offline
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Join Date: May 2009
Posts: 33
Default Any recent info?

Thanks Harrison, kind of pathetic that I could not find that Post. In any case, has anyone had one done in the last year? Any rough idea as to what it ended up costing? Thanks again.

-----------------------------------------------------------------------------
L5S1 Herniation and Annular tear
Over 10 epidurals,
DDD, 2 discograms (positive),
Countless attempts at conservative therapy.
Tentative Surgery date 5-26-09 (very much in jeopardy!)
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  #4  
Old 05-19-2009, 01:38 PM
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CharlesinCharge CharlesinCharge is offline
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Join Date: Sep 2006
Posts: 140
Default Was almost $125K for my XLIF fusion

I had the XLIF fusion last September, and while my insurance paid for it I can tell you that the grand total (and I went home that day, I did not spend a night in the hospital) was almost $125,000. That was for only one level, and a minimally invasive procedure! Most patients that I know get quotes for over $100,000 for ADR here in the U.S. when you add in everything (Hospital, labs, surgeon fee, device cost, anesthesiology, overnight stay in hospital, etc.). That is why so many of us have gone to Germany, where I paid $34,000 (including my airfare and my wife's airfare and all incidentals) for two levels.
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Charles B. Fainberg
Back pain suddenly started 9/05, no injury or cause
PT, Chiropractic, Epidural Injections - no help
DDD confirmed via discogram at L4/L5 & L5/S1 (with issues at L3/L4 but no concordant pain) 3/06
Failed SED (Laser Endoscopic surgery) 4/06
2 level ADR (L4-L5 & L5-S1) with Maverick disc at Stenum 8/06
XLIF Fusion (L3/L4) 9/08
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  #5  
Old 05-19-2009, 03:04 PM
Jdouglas Jdouglas is offline
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Join Date: May 2009
Posts: 33
Default ADR - Cost. Going it alone?

Thanks Charles. That is staggering. I just spoke to the Neurosurgeon's office and they won't have my cost until tomorrow, but I will post it when I have it. Once again I really appreciate the info.

-----------------------------------------------------------------------------
L5S1 Herniation and Annular tear
Over 10 epidurals,
DDD, 2 discograms (positive),
Countless attempts at conservative therapy.
Tentative Surgery date 5-26-09 (very much in jeopardy!)
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  #6  
Old 05-19-2009, 03:12 PM
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CharlesinCharge CharlesinCharge is offline
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Join Date: Sep 2006
Posts: 140
Default Be sure it is the TOTAL cost

Just be sure it is the TOTAL cost, not just the cost of the Neurosurgeon and the device. His office may not know exactly what the Anestheiologist will charge, plus the 3-4 nights in the hospital, all your meds and IV's in the hospital, the surgery room fee, the labs fee, etc. etc. Tell them you need the TOTAL cost, as that is what you are facing.
__________________
Charles B. Fainberg
Back pain suddenly started 9/05, no injury or cause
PT, Chiropractic, Epidural Injections - no help
DDD confirmed via discogram at L4/L5 & L5/S1 (with issues at L3/L4 but no concordant pain) 3/06
Failed SED (Laser Endoscopic surgery) 4/06
2 level ADR (L4-L5 & L5-S1) with Maverick disc at Stenum 8/06
XLIF Fusion (L3/L4) 9/08
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  #7  
Old 05-20-2009, 08:09 PM
Jdouglas Jdouglas is offline
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Join Date: May 2009
Posts: 33
Exclamation Anyone have any experience negotiating with USA hospitals for larger discounts?

I am dealing with Roper Hospital in Charleston, SC to get the surgery done and was curious if anyone had any experience "talking down" the price from the hospital? They are offering a 30% discount, but I have heard people say it should be much more. Anyone have any clue on this issue? Thanks for any help.


-----------------------------------------------------------------------------
L5S1 Herniation and Annular tear
Over 10 epidurals,
DDD, 2 discograms (positive),
Countless attempts at conservative therapy.
Tentative Surgery date 5-26-09 (very much in jeopardy!)
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  #8  
Old 05-21-2009, 10:12 AM
Maddie Maddie is offline
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Join Date: Oct 2008
Posts: 138
Default

I was given a price of ~$140,000 for five levels, involving the cervical and the lumbar, both fusion and ADR. And that was what they would be charging the insurance, whatever that means. This was in the eastern US, at a very big hospital.
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C3/4-5/6- Mod. ant., severe posterior bulging w. nerve root compression. Sev. narrowing of spinal canal with cord compression.

L4/5/S1- Mod. narrowing, bulging disc, significant hypertrophy of flava lig.

Highly allergic to all metals.

NEW: 3/16/2010: Successful surgery in Brazil w. Dr. Pimenta; Nuvasive NeoDisc at C5/6, and XLIF & ALIF at L4/5/S1 w. PEEK cages. No rods, screws, plates. Non-metal lumbar ADR not available at present time, so went with fusion.
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  #9  
Old 05-21-2009, 10:44 AM
Jdouglas Jdouglas is offline
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Join Date: May 2009
Posts: 33
Default Monopoly Money

The numbers in these types of discussions are almost nonsensical aren't they? It's just mind boggling to conceive. In any case, I still intend to proceed and go into debt. Time will tell if I am right or wrong. My surgery is Tuesday.
-----------------------------------------------------------------------------
L5S1 Herniation and Annular tear
Over 10 epidurals,
DDD, 2 discograms (positive),
Countless attempts at conservative therapy.
Surgery date 5-26-09
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  #10  
Old 10-16-2009, 03:11 PM
mattshell mattshell is offline
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Join Date: Oct 2009
Posts: 4
Default

Surgeons $ 5,500 This excludes MRI, Bonescan, Xrays, Labs, Surgical center
Facility $ 10,000 Labs, EMG.........
Anesthesia $ 1495
Prodisc-c $ 6,500
Total - $ 23,495
This is a surgical center... I was home two hours after surgery... Seven days post-op and neck has more movement every day... See Dr Saddiqui next Friday so he can look at x-rays hopefully no migration....
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