I'm a little confused about trying to talk to the folks at Barrow in AZ, because I ended up talking to someone at St Joseph's Hospital--but they are somehow connected...
Anyway, the self-pay numbers I was quoted were approximately $72,200.00 for GK and more like $85,000.00 for CK. She said they'd ask for about 20% as a downpayment, and then do payments over a year.
I don't even know how to process that.
I know that at my local hospital, they gave me a self-pay discount for my MRI of about 70% off of the total, but I don't know if the numbers quoted above include a discount, or if those are just the raw numbers for what the procedure costs before insurance would normally apply.
Should I have had my primary care doc call in my referral instead of trying to figure this out myself?
Well, after going back and forth with my insurer we are 99.99% done with getting what they will pay.
There "really" is no straight answer to what any procedure "really" costs.
The real question is what does it "really" cost each individual out of pocket.
However, for those less fortunate that must pay all costs out of pocket, I would recommend trying to negotiate all expenses down to what the hospital and docs have agreed to accept as "allowable charges".
This too will vary from insurer to insurer. I offer the following from my own personal experience with Dr. Lunsford's team at UPMC:
Doctor/Facility Total Charges Allowable charges Deductible Copay CoInsurance other amounts not covered Member Responsibility
UPMC PRESBYTERIAN SHADYSIDE (SD $54,344.00 $23,787.38 $800.00 $10.00 $1,187.70 $21.73 $2,019.43
UNIVERSITY OF PITTSBURGH PHYSIC $3,741.00 $1,047.00 $0.00 $60.00 $0.00 $0.00 $60.00
UNIVERSITY RADIOLOGISTS $868.00 $236.71 $0.00 $0.00 $0.00 $0.00 $0.00
UNIVERSITY OF PITTSBURGH PHYSIC $1,030.00 $304.00 $0.00 $0.00 $60.80 $0.00 $60.80
UNIVERSITY NEUROSURGICAL $15,598.00 $4,181.25 $0.00 $0.00 $0.00 $0.00 $0.00
UNIVERSITY NEUROSURGICAL $203.00 $107.00 $0.00 $60.00 $0.00 $0.00 $60.00
UPMC PRESBYTERIAN SHADYSIDE $39.25 $29.25 $0.00 $10.00 $0.00 $0.00 $10.00
TOTAL $75,823.25 $29,692.59 $800.00 $140.00 $1,248.50 $21.73 $2,210.23
My point in making this available for all is to show that the hospital and docs billed a total of over 75k, but AGREED with my insurer that would accept just under 30k. So is this what it "really" costs? I don't know.
At the end of the day, what each of us cares about is what it "really" costs us personally. In my case, I consider it very fortunate that my out of pocket is $2,210.83.
If anyone wants more details/info just send me a PM.
PS - sorry for the layout but I could not figure out how to upload an excel chart.
Excuse my ignorance, but are these numbers for real?? :o
My understanding from all the medical literature is that radiosurgery costs much less than conventional surgery. The numbers that I have heard about surgery say for example from HEI are about $100,000. How could GK or CK have a similar cost?
Also from what I know the cost for this surgery in some European countries, if you pay out of pocket is around the equivalent of $12,000-$20,000. The same is true for Canada (although we don't really see the amount, so I don't know an exact figure).
Assuming that the equipment/personnel/hospital stay etc are similar, how is a cost of $80,000-100,000 justified?
Sorry, but I am completely shocked.
Marianna
Many times insurance will deny; have you contested the decision to higher levels; keep doing this until you have reached the top.
Although my insurance said I was covered for the procedure, they nitpicked some of the charges, about 8k worth, as not covered. After one round of disputes, they paid them.
Also, suggest you contact Dr. Chang at Stanford and Dr. Lunsford's office (for GK) to see if their facilities have better options for private pay.
Real world results between GK and other fractionated treatments are almost identical. Why?
It's a matter of perception.
The physician charges were actually a minimal part of the charges. $2100 for the neurosurgeon, $3500 for the radiation oncologist, $380 for the radiologist. The biggest charges were for the actual use of the machine. I had LINAC treatment with 4 passes and each pass was broken down on the bill and averaged $14500 per pass. The charge for use of the head frame itself was also on the bill.
Hello;
I'm not so sure it's as simple as a 'single fraction." The tumor actually receives several hits in GK, I believe.