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