Thursday, July 23, 2009

How Much Does It Cost?

What does your health care cost? Your office copay may be $15 or $20, but that’s just a sliver of what it actually costs to provide the care. Here’s a sample of common medical treatments and the average charge from hospitals or clinics. These are the charges prior to any discounts negotiated by a health plan or insurer and are calculated using 2003 charges.

Medical Treatment

Description

Cost

A common cold, office visit

You feel rotten, go to the doctor and are told to go home, get plenty of rest and drink fluids.

$80

A common cold, ER visit

You feel rotten, and instead of going to your clinic during the day, you wait until midnight and go to the ER.

$181

Sore throat, office visit

Your throat hurts, you go to the doctor. Price includes visit with physician and Strep test. Test was negative.

$109

Sore throat, ER visit

It’s the middle of the night and your throat really hurts. You decide to go the emergency room. Includes ER charges and test for Strep. The test was negative.

$406

Ear ache, office visit

Your 2-year-old daughter is pulling on her ear. You go to the clinic. Office visit and exam. No infection is diagnosed.

$78

Ear ache, Urgent Care visit

Your 2-year-old daughter is pulling on her ear. You go to Urgent Care. Visit and exam. No infection is diagnosed.

$111

Ear ache, ER visit

Your 2-year-old daughter is pulling on her ear. You go to the emergency room. ER visit and exam. No infection is diagnosed.

$151

Tubes in ears

Your child has had chronic ear infections. The decision is made to insert tubes his ears. Price includes office visit 30 days before procedure and 30 days after, day surgery charges, antibiotics, drops and decongestants.

$2,719

Diabetes check-up

You have been diabetic for six years and your diabetes treatment has been going well. This is your annual trip to the clinic to see the doctor for a diabetes checkup, including cholesterol and blood sugars (HbA1c) checks.

$535

Chest X-ray

You go to the clinic with a bad cough. Your physician thinks it may be pneumonia and orders a set of X-rays to help make the diagnosis. Price includes clinic visit, X-ray and reading of the results.

$183

Diagnosis and treatment of Gonorrhea

The prevalence of sexually transmitted diseases is a public health concern. This price includes an office visit, test and treatment of Gonorrhea with an antibiotic injection or oral antibiotic.

$215

Allergy shots

You have been diagnosed with allergies and go to the clinic each week for a shot. The visit does not include seeing a doctor.

$64

Colonoscopy

Full, flexible colon scope test conducted by specialist on an outpatient basis. Includes test and reading of the results.

$1,985

GI Endoscopy

Conducted by a specialist. Scope exam of the gastro-intestinal track on an outpatient basis. Includes conducting the test and reading the results.

$1,398

Skin cancer diagnosis

A black, purple odd shaped mark on your arm requires a consultation with a specialist, biopsy and removal of skin lesion.

$1,533

Stress test

Your primary care doctor orders a stress test. This price includes a trip to the specialist, administering test, reading results.

$1,885

Eye exam

Exam by ophthalmologist.

$176

Allergic reaction to a bee sting

Price includes the ER visit and diagnosis, in addition to drugs to treat allergic reaction. Treatment could also include a hospital stay for a severe reaction.

$1,050

Broken ankle

You broke your ankle playing soccer. Includes trip to the ER, X-ray of ankle and applying short leg cast.

$1,386

Step on a rusty nail

You step on a nail while taking a walk. Price includes laceration on foot, ER fee, repair, tetanus shot or antibiotics if needed.

$1,030

Broken arm

Your child jumped off the swing set. Price includes ER visit, X-ray, simple cast.

$2,523

Tonsillectomy

Your child (under 12) needs her tonsils removed. This price includes a pre-surgical office visit, surgery at a one-day surgery and any related post surgical visits with in 30 days.

$4,875

Frostbite treatment for a hand

Your child loses her mitten on one of the coldest days of the year. You make an urgent care office or ER visit. The price includes diagnosis and treatment and excludes critical cases.

$321

Diagnose mono

Your teenager is run down, extremely tired. A trip to the clinic and Heterophile antibodies test shows mono.

$152

Therapy session

You see a licensed therapist. Does not include prescriptions drugs or psychiatrist evaluation.

$152

Outpatient chemical dependency treatment

You attend 21 to 30 days of alcohol- or drug-related chemical dependency counseling through a hospital’s outpatient program.

$4,487

Cut on the hand

You’re using that new knife and you slice into the tendon in your hand. Price includes an ER visit, complicated stitches, tetanus shot if needed.

$3,066

PAP test

Woman of childbearing age, includes exam by gynecologist, test and reading of results.

$229

Routine mammogram

Women 35 and older, includes the test and reading of results.

$125

Prostate cancer screening test (PSA)

Includes office visit for man age 50 or older, blood draw and PSA test.

$285

Having a baby

Price is based on “perfect” pregnancy, including routine prenatal costs, no risk factors to mother, uncomplicated vaginal birth.

$8,751

Hysterectomy

Simple hysterectomy, not caused by trauma, cancer, etc. Includes physician charges, hospital surgical and room and board charges and follow-up visit.

$21,686

General physical, charges vary by age:

Exam of a person in good health. Simply a physical, not a problem-focused clinic visit.

Well-baby check

$134

Age 5 to16

$232

Age 18 to 39

$302

Age 40 to 64

$371

Age 65 and older

$323

Prescription Drugs

2005 Average Wholesale Price. Prices show difference between a prescription drug co-pay of $25, for example, and the retail price of the drugs received. Prices are based on common dosages for co-pay arrangements.

Drug

Description

Cost

Ortho-Novum

84, 1/35 tablet birth control pill, (standard three-month prescription with one co-pay).

$141

Prozac

30, 20 mg capsules, used to treat depression.

$129

Generic for Prozac – fluoxetine

30, 20 mg capsules

$32

Zyrtec

30, 10 mg tablets used to treat allergies.

$70

Lipitor

30, 20 mg tablets used to treat high cholesterol

$114

Adderall

60, 20 mg tablets. Used to treat ADD/ADHD.

$179

Generic for Adderall, D-amphetamine

60, 20 mg. tablets.

$82

Ritalin

100, 10 mg tablets used to treat ADD/ADHD.

$94

Generic for Ritalin, Methylphendidate

100, 10 mg. tablets.

$38

Concerta

60, 18 mg tablets used to treat ADD/ADHD.

$182

Source: Minnesota Council of Health Plans, 2005.

This document reflects Minnesota health plan commercial and government programs data, analyzed by Data Intelligence, LLC.

For information, contact: Eileen Smith smith@mnhealthplans.org


In a democracy, silence is not golden; it is condonance in the face of injustices; it is fear, where the thought of reprisal fosters control. – Rodney A. Davis

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