WHY THE FUCK does a CT Scan cost $4,069.81??!!!!11

[jus_the_facts]

....the total bill for an ER visit for a kidney stone without insurance...results in a 'scrip of only 15 Lortabs and COSTS $4,700 MU'FUCKIN' DOLLARS...when a simple measly $400.00 x-ray could have told us what we already knew...but 4K+...goddamn criminals. :rant: :nopity: x(

[soleft]

1. If you had insurance it probably would have twice as much

Waiting for MRI bill (and results as well!) - the copay will no doubt result in homemade Xmas gifts this year.

[jus_the_facts]

3. The bill just says amount due...doesn't even say it was actually FOR a CT Scan....

....the hospital offers to help you get a medical card...but income is too high to qualify for one...yet not enough to buy insurance...I hate this world. :evilfrown:

[triguy46]

20. Does the bill list a "CPT" code? If so I could look up...

the usual and customary charge for the same procedure if done here in OK.

[triguy46]

15. Let me attempt to identify the issues driving high costs:

First some definitions: When I use "cost" I'm referring to the actual expense incurred by the facility, made up of salary for the tech, cost of lights, cost of electricity, HVAC, supplies used. That is different than "charges" which is the retail marked up price.


1. Uncompensated care. For all the care that is provided by a hospital, a significant portion is either at below what it costs to provide the services (for instance Medicaid reimbursement is generally less than the cost), or uncompensated because of use by an unisured individual who cannot pay for service, or true charity which doesnt happen much. In addition, hospitals will increase costs to offset losses from Medicare; these losses may have nothing to do with the CT, but get spread around everywhere. Since Medicare does NOT pay what it COSTS, all the rest of us have to make up the difference.

2. Competition. Rather than drive down prices, competition in health care has increased prices. Since every facility HAS to HAVE a CT or MRI, the costs of those test get passed on the patient, makes sense. However, due to competition, there is excess capacity in technology such as imaging. Actuarily speaking, within a statistically sufficient population, you can fairly accurately estimate how many CTs or MRIs are needed based on disease modeling. That number doesn't change too awfully much (in theory), but since every facility has a CT, they are just slicing the pie smaller volume wise, even though the fixed costs don't change. So part of the high price is due to the fact that there is an abundance of technology, and part of that is that you don't want to wait in line or go to a hospital across town. In addition, this "competition" has led to the expolsion in health care marekting, an expense that gets passed on to each patient visit. The feel good, "We care more!!!" TV ads hospitals run cost real dollars and your CT is paying for a portion of it.

3. Non-clinical expenses. Due to the mountains of paperwork required by insurance companies, and regulatory bodies, the amount of non-clinical support and service is very large. Those costs, accounting, medical records, accreditation, reporting, all get passed on to the patient visit one way or another. The beauty of a single payor system is that all that administrative bullshit, including how I've made a very nice living, goes away. One bill to one payor.

This will not help, but I hope it does explain.

[Rabrrrrrr]

18. Aye on all that! Talking of overhead, NYU Hospital has about 12 employees per bed

Granted, NYU is a teaching hospital so its staffing is higher (I would assume) than a regular hospital, but I imagine even a regular hospital has a high employee:patient ratio.

NYU - 750 beds and about 10,000 employees.

Do you know what a regular hospital might have? NYU is the only hospital I've worked at.

[triguy46]

28. Actually just the opposite.

Hospitals have one fee schedule, from which they are allowed to 'discount' based on contractual agreements such as HMO's PPO's or Medicare. As an uninsured patient, this is probably their 'top line' full price retail charge. Very few insurance plans these days pay the top line, they all insist on discounts in return for being on the provider panel. Kind of bass ackwards, but then we are the only country that does health care this way.

[Lionel Mandrake]

33. That's correct (but not right).

Those who can least afford it are charged the highest price. This is Robin Hood medicine in reverse.

[seemunkee]

2. Wow, thats a lot

I had a ct-IVP done 2 weeks ago and it was $2121.

[jus_the_facts]

4. This is beyond outrageous....he knew he had a stone...an xray would have shown it...

...and the cost would have been in the hundreds instead of thousands...my roomie had to have surgery back in the early 90's for a kidney stone and the entire bill for that was only a few hundred dollars more than this bill for a useless CT scan. :(

:loveya: J. :hug:

[GirlinContempt]

5. I can't believe they charge ANYTHING

I'm serious. I think it's fucking outrageous. I can't imagine being in that position, and it makes me furious to think of others being forced to shell out exorbitant sums for a fucking essential service.

[jus_the_facts]

7. I'm seriously ill just dealin' with the fact that an xray would have been enough...

...yes it should be criminal to make money off of healthcare...yet we're now in even more debt and eventhough he passed the one stone...he has a few more floatin' around in both kidneys...and has to work 10 hour days out in the 95+ degree heat of Fort Worth, TX...he is literally in HELL. :cry:

[Gormy Cuss]

13. We wouldn't want socialized medicine in the states.

Look at how screwed up it is in Canada, where one needn't think twice about heading off to the doctor to investigate that pain. Why, I'll bet that you people never have thoughts like "why did the doctor order an expensive CT scan, when an X-ray would be cheaper?"
**sarcasm off*

The worst of it is that the CT scan doesn't cost $4000 or even $2000 as another poster mentioned. Those are the billing prices which are set much higher than cost in part because of negotiated discounts with insurance companies. Uninsured patients pay full price unless they are fortunate to be able to negotiate a discount or are broke enough to qualify for the relief fund.

[triguy46]

22. We're the only country that does it this way.

Either we're geniuses or idiots.

[HughBeaumont]

25. That's Dumberica for you!

War is great business. Helping people isn't.

There's always enough money for bombs, aircraft carriers and occupying soverign countries that have no means of retaliating. But somehow, the well just always seems to be dried up when it comes to little things . . . like general infrastructure repair, housing, education, school upgrades, universal healthcare, job placement, helping displaced workers, etc etc etc.

We're trained like rats to think that anything even slightly less than the wealthy getting their way 700 million fold over the little guy = "HANDOUTS!"

In Dumberica, it's not about "Well, how can this help others?" It's all about "Well, how will this make me RICH?"

And as long as this mentality continues, we as a nation will never, EVER progress.

[begin_within]

6. Our friend had a heart bypass operation last year... $211,000

Fortunately he didn't have to pay it, his insurance did.

[Connonym]

8. Because they can

unmitigated greed. The fuckers. You're in pain, you're upset, you're not offered choices or given costs up front, they out and out screw you over while you're down. I can feel my blood pressure rising just thinking about it.

Sorry, dude.

[Rabrrrrrr]

9. And unlike any other service provider, the real price doesn't have to be close to "estimate"

"Oh, this should be about a $4,000 procedure".

Then you get the bill, and it's $82,000, and there's nothing you can do about it.

A plumber or construction guy or auto mechanic or house painter or, hell, even a lawyer would have their asses sued off for it. But in the health care industry, the consumer gets sued for not paying.

[dembotoz]

31. watch the blood pressure

the can bill you about that too

[Connonym]

41. Not really funny because it's true but LOL nonetheless

[Heddi]

10. I'm an RN--just so you know, an Xray would not show kidney stones

or not to a degree as to be a definitive diagnosis. THat's why the CT scan--also, to rule out other causes of lower flank, abdominal, lower back, etc, pain.

[jus_the_facts]

14. Amazin' that 15 years ago....an xray showed the stone he had...and even...

...all the gas built up in his bowels from his left kidney bein' blocked off with a stone in the tube between his kidney and bladder...the doctor flipped out on the fact that he could see the gas in his intestines on an XRAY...that also showed the huge stone which had to be surgically removed...no CT scan was needed then...go figure.

[Heddi]

30. I'm not saying that an Xray CAN'T be used

but rather that a CT scan is better at detecting other issues that may cause similar signs and symptoms, like gallstones (just off the top of my head) and other soft-tissue causes of pain. It's what's called Differential Diagnosis----rule out bleeding, rule out gallstones, rule out so many other things that can cause similar pain or symptoms or whatever.

And I'd be interested as to why he'd have excess gas in his bowel if he had a kidney stone, considering there really isn't any connection between kidney and bowel. And I'm further confused as to why a MD would be "flipped out" that they could see gas on an X-ray...Seeing gas in the bowel/colon is a very common thing to see on an Xray.

THere are many procedures and diagnostic tests that are done now that weren't done 30, 10, or even 5 years ago. THat doesn't mean that doing these diagnostic tests now are useless. IT just means that there have been medical advances, and better ways of detecting and diagnosing problems.

Imagine the outrage on this board if someone had gone in for "kidney stone" pain, was given an Xray and the Xray showed nothing. THen they go home, and a week later find out they've got an internal bleed, or gallstones, or something else that could have been detected through CT. Can you hear the howling now? WHY DIDN'T THAT MORON DOCTOR AND HIS STUPID ASS NURSE GET ME A CT SCAN THAT WOULD HAVE SHOWED? WHY DID THEY ONLY DO THE XRAY????????????

[Hawkeye-X]

32. Hi heddi! LTNS!

:hug:

[ironflange]

19. I went through kidney stone fun about ten years ago

Went to ER, waited three hours (naturally), and then got hooked up to an IV. They sent some sort of xray dye into me, then took a picture about an hour later. There it was, in all its glory, about halfway down the tube. However, when another xray was done, it was gone. All that IV fluid flushed the damn thing out.

So how much did all this cost? Nothing. I'm in Canada, so it was free. Having to wait for a couple of hours is a pretty fair trade-off. I feel really really sorry for the way you good folks get consistently screwed by your system.

PS. The stone appeared (YOICKS!) a short time later, it was the size and shape of a mung bean. No wonder it hurt so bloody much. I wanted to keep it for a souvenir, but the doc sent it off to be analyzed.

[supernova]

11. You're being charged the high rate

Insurances firms can bargain for lower charges from the hospital, individuals can't.

So, the hospital charges Aenta their bargain rate of say 2100. But it ordinarily costs 3500 for a CT. Because you don't have ins you don't get the bargained for price.

Yes, it is evil. And I'm sorry. :hug:

[triguy46]

29. This is correct. Those that 'have' get a better deal than those who don't.

Call the billing office, explain your situation and offer to pay $25 per month. This is enough to keep them from claiming non-payment due to your good faith effort. But its slow enough that they might offer a deal.

[gmoney]

12. try wheeling and dealing...

A friend managed to beat the hospital down on pricing for his wife's hysterectomy from like $40K to around $10K.

Start by asking what the amount would be "repriced" to if you were a member of the network, and aim for that.

If you're a big enough pain in the ass, they'll eventually cave in just to shut you up. Could save you a few thousand bucks.

[ncrainbowgrrl]

23. sounds like good advice.

I hope to never need to use it, but I'm gonna file that technique away somewhere in my gray matter- under insurance.

[Deep13]

16. Apart from all the other inefficiencies in our system...

...such as ordering the use of a machines simply to pay for its purchase, CT machines are very expensive to purchase. Sometimes a flat Xray can answer the question as well, sometimes it cannot. CT has much higher resolution.

[triguy46]

26. Once the technological cat is out of the bag....

Its hard to stop the use of technology. From the docs' point of view, if the community or even the national standard of care is an abdominal CT as part of a workup then you can expect to get one UNLESS you refuse. The refusal part is very tricky and may result in your doc discharging you from their practice.

But this is correct, the availability of technology drives its use. In our health plan of over 7500 covered lives, the biggest single jump in expenses has been in imaging technology, not in Rx or cancer care or transplants. The use of MRI for every little ache and pain. That said, MRI is a fantastic tool that can give some very detailed information. ON the other hand, for most, the treatment will end up being the same. hard to believe, but I had a knee scoped 7 years ago just based on physical exam. The orthopedist called the insurance company and said "He's going to be scoped whether he has the MRI or not, do you want to pay for the MRI?" They did not make me have an MRI.

[raccoon]

17. That sucks. Sorry, jus. nt

[ThomCat]

21. Hospitals take every opportunity to charge you massive

amounts of money. They are under huge amounts of pressure to generate huge profits, even when they are supposedly not for profit.

People without insurance, who can afford the least, are made to pay the most because you haven't negotiated a rate in advance.

I'm sorry. :(

[triguy46]

24. It does not "cost" $4,069.81.

In the discussion of our so called health care system, it is important to remember that the actual cost to the hospital is a fraction of what they charge you. If in some way we could move to a different system in which cost was the primary consideration, then we would be well on the way.

[KitchenWitch]

27. Because the hospital has not paid off the bill for the machine yet.

:grr:

Thank you sir, you just made one of our payments.

[Wapsie B]

34. The points made above I agree with, however, administrative costs

and overhead is the 800 pound gorilla rarely mentioned. If it's talked about at all it's presented as almost a non-issue. All those MBA's & MSN's do not work for minimum wage. When you have all those non-revenue generating positions in a facility those costs will be passed on to the patient.

I've always wondered though as to how it's done elsewhere in the world. How top-heavy is your average hospital in Paris or Montreal?

[Akoto]

35. My advice ...

If you don't have insurance and can't afford to pay, look for a lawyer. Many of them will charge very reduced rates, or delay payment, to help you with medical billing. Nothing makes the hospital back down quite like the shield of a knowledgeable attorney.

A few months ago, my mother had a heart attack and ended up in the hospital. They did surgery to find the blocked artery without telling us that they couldn't fix it. They'd need to send her to a second hospital, where the same procedure would be repeated again as well as clearing the trouble artery. The bill came out to about $35k for each hospital, not counting specialists' fees.

The hospitals wouldn't so much as budge for us, but that changed when our attorney came on-board. She went at it and got things down to about $10k total. Still pretty devastating, but still a whole hell of a lot better than $70k.

Among other things, the lawyer will go through your bill to find areas where the hospital has obviously bulked up the price. For example, ours found where we were being charged 10x or more the worth of pills, etc. When you're armed with these facts and genuinely can't afford to pay, the hospital will probably be more inclined to negotiate, because they realize a court will be on your side.

A side benefit is that your lawyer can send a cease and desist to the hospital and any collections agency they might enlist against you. After that point, the hospital/collections can ONLY contact your arbitrating attorney. This doesn't make the problem go away, but it keeps the bad guys from harassing you all the day long. Violating the cease and desist can very well get the hospital's bill thrown out of court.

[RushIsRot]

36. I really do not know if this works. I have not tried it yet, but my

neighbor has mentioned something about arbitration for lowering hospital bills. It might be worth looking into. If all else fails, what is wrong with sending them $10 a month? It'll likely keep the collection agencies away from your door.

[flamingyouth]

37. Geez, I'm so sorry.

They do usually use CT scans to diagnose kidney stones now, not x-rays, but yeah, that's outrageous. I'm just trying to remember what my kidney CT scan from last fall cost with insurance and I think it was about $1,100, if you want a comparison. (I had a small stone they were trying to find but it ultimately turned out I had bladder cancer ... even though it them them two months to find that tidbit out!)

Anyway, I hope he feels better. I would try to see if they have a charity or uninsured program? Some hospitals do. Take care, and all my best. :hug:

[Submariner]

38. ULTRASOUND ???

My doc says I might be able to get away with an ultrasound exam for $167 instead of the CT. Did your doc offer ultrasound?

The lithotrisy, the anticipated treatment to pulverize the stone, is $4000 according to the hospital. I'm presently trying to negotiate that down to $2000 CASH....take it or leave it! If they kiss me off, I'll start hospital shopping locally. I refuse to pay these out*uckingrageous costs without a huge fight.

To add insult to injury, I just found out 2 weeks ago that my "guaranteed for life" VA health care benefit was scrapped by that yellow-bellied draft-dodging coward 5 deferment Cheney. I guess they needed to sacrifice the vets to pay for their Iraq folly.

[hippywife]

39. I've had kidney stones about 20 times

in my life because I tend to develop uric acid stones on a regular basis. I've never had one diagnosed by a CT scan. Always with a regular x-ray and then an IVP (x-ray with the addition of contrast.) I've had them so many times now, the doc takes my word for it. Even when I was in the ER a couple of years ago with the last one, the doc there (who didn't know me from Eve) said they see so many kidney stones, there was no sense in doing expensive diagnostic testing.

No doctor worth his degree would go immediately to a CT scan on a patient presenting with the classic symptoms of a stone, especially when it wasn't the first time patient has had a stone. That is just crap. Anyone who says that it's not is too entrenched in the system to see the forest for the trees and is buying the line of hooey these profit grabbers are dealing out.

And the suggestion that you pay them $10/mo may work with some hospitals but not all these days. When I had my lithotrypsy on the last stone because it was way too large to pass, that hospital insisted on full payment in three months and if you couldn't do that, they would happily send you a loan application that carried 18% interest. Of course, they didn't advise us of that before the procedure, only after the bill was sent. They had plenty of opportunity because it was not arranged out of an emergency room. We got a 6% loan at our credit union and paid the bloodsuckers. (Don't ever, ever go to SouthCrest Hospital in Tulsa unless you're dying and can't reach another in time or have lots of money and nothing else to do with it.)

Hell, I even have insurance and it takes about a third of each of my paychecks to cover the premiums for me and my husband. And even then, the co-pays (20%) on a procedure are difficult for us to pay. I just had gall bladder surgery and I'll still probably be making payments to the hospital for a year. (Luckily the one I went to this time is content with that.)

The motivation of profit MUST be taken out of healthcare in this country NOW!

[colinmom71]

40. Wow... $4K+ is rather much...

I had a kidney stone attack during Christmas of 2004 and the entire ER bill was about $2300, and yes that included a CT scan and a nice Dilaudid IV... The CT scan was definitely necessary for me since I also had severe tenderness in my back (also had a bad kidney infection), and two stones were found. I think the actual CT scan charge was about $1100, right about half of the ER visit's total charges. I also wound up with several prescriptions, including a powerful anti-inflammatory and Oxycontin for pain, so I can't believe they only gave you 15 Lortabs! Wow...

One issue with your bill could be that the CT scan was miscoded, resulting in a higher charge than is actually charged for the procedure performed. I saw this kind of thing happen on occasion in the NICU my son stayed in. They had a rather elaborate bar code label system for durable equipment, like IV pumps or diagnostic tests, and sometimes the code reader would double read a bar code or the wrong code sticker was read off for the wrong patient's bill. DIdn't happen often, but I do recall the front desk staff once or twice mentioning some errors in charges coming back up from billing for them to resort.

Ask for an itemized bill from the hospital so that you see each and every individual charge that was credited to your file. You may spot some mistakes or charged procedures that weren't performed on your case and can then challenge the wrongful charge. The hospital will just go back to the doctor's orders in the chart and can confirm if there's a mistakenly reported item encoded. If there is no error of coding, then you can dispute the charges (as someone said above) along the lines of whether *your* bill reflects the normal, customary, and average charge for those treatments. Usually just disputing the charges alone will get your bill reduced to some degree... Best of luck and I'm sorry you're having to deal with this...