Putting a price on colon cancer

Among my issues right now, paying for medical bills isn’t one of them. The Kalamazoo Gazette has provided its employees with Cadillac coverage, and since my cancer was diagnosed in mid-October,  my medical bills have exceeded $44,000 and I’ve paid exactly $12.53 out of pocket — and the latter was a mistake.

Still, I was curious to see exactly how much I’ve cost Aetna in the past few months and went on their website to add up my bills. In true journalist fashion, I created a spreadsheet and come with up some interesting findings.

One is that the one of the big benefits of insurance is not just that they’ll cover the bills — they also knock down the costs by negotiating with health-care providers. In total, my various providers have billed $44,405 since the original colonoscopy (with some bills not showing up yet). Aetna has paid $33,290, or about 75 percent of the billed costs. The providers have written off the remainder.  So just be being insured, my medical costs went down by 25 percent.

In studying the numbers, there seems to be little rhyme or reason as to these negotiated fees. It’s certainly not an across-the-board set percentage: Kalamazoo Anesthesiology has gotten 95 percent of what they’ve billed; by comparison, my first chemo treatment was billed at $147 and Aetna actually paid $22.44. 

(In fact, K’zoo Anesthesiology was better paid than my surgeon for what I can tell was, at best, about the same amount of time and effort. KA received a total of $3,000 for my hospital stay, which includes sedation during the operation and a quick daily check of my epidural IV for the first three days in the hospital, for which they received $273 per visit. The surgeon  got a total of $1,800, which included a pre-surgery office visit, the surgery itself and a daily hospital visit that definitely lasted longer than the KA visit to check my epidural.)

Below is a look at the numbers. It includes the cost of diagnosing the cancer, surgery and a five-night hospital stay, and cost of working with oncologists to get started on chemo (which includes outpatient surgery to install a Port-a-Cath, a semi-permanent IV line in my chest to be used to deliver the chemo meds).  

Cost of diagnosing the cancer

  • Colonoscopy:       $1,212 billed          $993  paid
  • Labs/pathology: $936  billed            $555  paid
  • CT scan:                   $4,936 billed         $3,173 paid
  • Office visit to deliver diagnosis: $153  billed            $125 paid
  • Subtotal:                 $7,855  billed    $5,229 paid

Cost to remove 12 inches of colon

  • Surgeon’s fee:  $3,984  billed        $1,802 paid
  • Anesthesiology:  $2,400 billed      $2,280  paid
  • 5-nite hospital stay:$21,663 billed       $18,296 paid
  • Epidural during hospital stay: $864  billed           $821 paid
  • Labs: $402 billed             $298 paid
  • Subtotal: $29,313 billed      $23,498 paid

Post-surgical cancer treatment  

  • Consult w/ K’zoo oncologist: $430  billed         $251   paid 
  • Consult w/ U of M oncologist: $415   billed         $273 paid
  • Port-A-Cath  installation: $6,548  billed      $4,331  paid 
  • Labs: $248 billed          $33  paid
  • 1st day of chemo: $147  billed          $22 paid
  • Subtotal: $7,823 billed     $4,942 paid

Grand total: $44,405  billed   $33,290 paid

                                             

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2 Responses to “Putting a price on colon cancer”

  1. Niki Waldron Says:

    Julie – It looks like your people were better paid than I’ve seen. With Chris’ most recent ER visit (ca. 4 hours) for a kidney stone the total billed was $7581 but the negotiated actual paid was $787. We also have a cadillac insurance policy but it makes me sad that someone without insurance would have to pay the significantly higher amount!

    Take care. Our thoughts and prayers are always with you.

    Niki

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