Costs of some of my procedures this year

In another thread, someone was talking about costs related to our journey.  THis past week, got current data from my hospital and my uro/surgeon.  The surgery fees just don't strike me as outrageous, its the hospital, should be criminal.

Hi David,

I've had a similar experience as well. The hospital fees are not just confined to serious procedures such as we have experienced. My wife had surgery on one of her fingers. The orthopedic surgeon cost about $2100.00 including 3 months of follow up visits. The hospital fee was around $11000.00. The only medicines were a local nerve block and some antibiotics, and less than 6 hours in the hospital.

The news is filled with stories about the high cost of health insurance but I can't recall hearing about the reason for it.


Wishing you luck with your next week's treatments,
Bob

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Age 70, First ever PSA 7.8 taken June 2008, Biopsy July 2008, 10 of 12 cores positive, Gleason 3+3=6
da Vinci surgery December 10, 2008, catheter removed December 29 2008
St. Lukes Hospital, Bethlehem, Pa.
Dr. Frank Tamarkin
Prostate weight 73.0 grams, Gleason 3+3=6, stage pT3a
Tumor locations: right anterior apex, right posterior apex to mid
left anterior mid to base, left posterior apex to mid
extensive perineural invasion in right anterior apex, right and left posterior apex to mid
seminal vesicles negative
Four PSA tests undetectable, latest Oct 30

Thank you Bob. I should add, that these are raw numbers, they haven't been through the "middle man" step, where they negotiate what will actually be paid.

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Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.

Yeah, I forgot about that part. I don't remember what the final cost to the insurance company was. I wonder what the charges would be for someone without insurance.

Regards,
Bob

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Age 70, First ever PSA 7.8 taken June 2008, Biopsy July 2008, 10 of 12 cores positive, Gleason 3+3=6
da Vinci surgery December 10, 2008, catheter removed December 29 2008
St. Lukes Hospital, Bethlehem, Pa.
Dr. Frank Tamarkin
Prostate weight 73.0 grams, Gleason 3+3=6, stage pT3a
Tumor locations: right anterior apex, right posterior apex to mid
left anterior mid to base, left posterior apex to mid
extensive perineural invasion in right anterior apex, right and left posterior apex to mid
seminal vesicles negative
Four PSA tests undetectable, latest Oct 30

Since late 2007, when I met my uro/surgeon and his practice, I have only paid 40.00, yes forty bucks out of pocket. I talked to their Business Mgr this past Friday, in theory, had some unpaid amounts of almost 1,000.00, she said for me not to pay any of it, they were getting the insurance to eat it. Feel fortunate there.

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Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.

Hi David,
DO you know the cost of your IMRT? I'm curious since i have to choose between my IBM retiree insurance and Medicare supplement just in case I have to go that route (hopefully not) . The IBM insurance has a co-pay of 20% of all labs and hospital but costs much less the Medicare supplement which has no co-pay..

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Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1

Ed, I am suppose to get a print out for the first 4 weeks of IMRT this Monday or Tuesday, I will be happy to post them when I get it.

When I had old style radiation 10 years ago, from what I remember, it was costing close to 5,000 a day per treatment. So it will be interesting to see what it is now.

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Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.

Thanks David.

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Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1

David,
Hmm, I figure I paid for $0.0002 of your bills. Remember that little 1/10 of a second pinch you felt during your second to last exam? Well, I paid for it. You're most welcome, brother. ;-)
Jeff

So that was you, Jeff. Finger didn't feel familiar. lol.

Having my zap at 1230 today instead of 1430, then off to uro to have sp cath changed out, and supposedly a full bladder neck dialation in his office, still may not happen unless he convinces me he can drug me to oblivion with pain killers first.

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Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.

A note on biopsy costs...
Since this thread is dedicated to costs, I recently posted that the cost of 5 visits to the urologist, including a biopsy, cost 3k. This is consistent with what I have found online. A typical biopsy procedure runs around $ 1300.00 and that includes the pathology report. While I paid a series of co-pays, the actual bill paid by the insurance company in my case was $ 2,200.00 for all the visits, the biopsy, and a few urine tests. I also had a complication in that I was allergic to the antibiotic that was given to me (Bactrim).

Tony

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Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
Hormone Therapy May '07 to September '09 ~ Currently off.
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (October 7, 2009): <0.1

My journey is at: www.caringbridge.org/visit/tonycrispino

My InfoLink page is at Tony's Prostate Cancer InfoLink Page

STAY POSITIVE!

Also another note about my surgeons pay for the Davinci procedure. My doctor earned around 3k for his part. This included the consultation, the procedure, follow up, and about ten pages of dictated reports. The hospital was far more expensive than the doctor. This would seem to be counter point to the comments here about doctors doing procedures for the dough. In fact, most urologists make far more in the clinic than in the operating room.

Tony

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Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
Hormone Therapy May '07 to September '09 ~ Currently off.
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (October 7, 2009): <0.1

My journey is at: www.caringbridge.org/visit/tonycrispino

My InfoLink page is at Tony's Prostate Cancer InfoLink Page

STAY POSITIVE!

I agree with you Tony. BTW, I looked back, my 3rd and final biopsy was about 1,200 including pathology. No doubt there are some very rich doctors out there, but there are many that are dedicated, humble, and modest, and actually enjoy what they do, and the good they do to their patients. Considering the cost of their educations, outrageous insurance costs, as well as the standard costs involved running any business, I doubt that most are "rich".

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Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.

Tony,
$3K is still not chump change. I figure the total time my Uro spent on me was: Biopsy 1 hr max.. (more like 1/2), the consultation 1/2, second consult 1/2, 10 min call before surgery, Surgery 2 hrs (there was someone scheduled 2 hours after me. ) Notes were dictated as he was slicing and dicing. 1/2 follow up. So that comes to 6 hours max or 500/hr. He did go to med school, has to pay for insurance and equipment. Say that is half. So the wage is now $250/hr. The same as a shark divorce lawyer. Lawyer or Uro- Either way you end up with something shoved up your butt, a body part missing, and your wallet lighter.
I'd rather give my $$ to the Uro.
Jeff

I read this over a year ago, and I'm sorry I don't remember all the details, but on another chat board a solo urologist wrote anonymously that he devoted one day a week to prostate biopsies, times four for a month, which essentially covered all his expenses - rent, insurance, office expenses (including staff salaries), etc.  He said he just had his staff line them up; he only needed a few minutes with each patient and could do a whole bunch of them quickly.  Very lucrative work - payment for everything else he did falls to the bottom line - and one reason the relative incomes of urologists compared to other medical specialists has jumped so much since the advent of the PSA test.

Seems like instead of bashing educated and skilled doctors for their fees, turn your attention to the sports page, I just read where some pro basketball player just got a 55 million extension for 5 year. Come now, 11 million a year to bounce around a ball on the floor and make hoops? No matter how much one loves pro sports, it is just entertainment.

I don't begrudge any of my doctors or surgeons for what they may or may not make. A person should think about that next time they get put under, and a surgeon is about to open you up. I want the best, the most experienced, and the most skilled. I don't even care what basketball team he likes.

David in SC

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Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.

Tiger woods was just named the newest billionaire by Forbes. When you think how much sports figures make, you wonder about our priorities.

Tony

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Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
Hormone Therapy May '07 to September '09 ~ Currently off.
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (October 7, 2009): <0.1

My journey is at: www.caringbridge.org/visit/tonycrispino

My InfoLink page is at Tony's Prostate Cancer InfoLink Page

STAY POSITIVE!

And let's not forget about Paris Hilton and others of her ilk.
Don't get me wrong, I was thinking the Uro was well worth the money. Personally I think ambulance personnel are the most underpaid for what they do but I'm sure you can find other examples in our strangely prioritized society.

Paris is an Heiress. She was born into the lap of luxury. However, the Hilton estate was founded by a savvy business man and had been through the hands of his kids who also are work-a-holics. I have done much work for them and know what they created was a fantastic business employing over a hundred thousand people.

But I bet Tiger Woods had more fun earning his first billion than Barron Hilton did after his father gave away his original vast fortune.

In any case, both, and most doctors, are better business people than I am. But I have to wonder how much Tiger would have earned if he putted like I do.

Tony

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Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
Hormone Therapy May '07 to September '09 ~ Currently off.
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (October 7, 2009): <0.1

My journey is at: www.caringbridge.org/visit/tonycrispino

My InfoLink page is at Tony's Prostate Cancer InfoLink Page

STAY POSITIVE!

There is an intertwined reason why hospital costs are so high all centuring on those who receive charity care and those who either pay nothing at all or "5 a month for life." A hospital would likely do very well if ALL of its charges were negotiated and PAID, rather than having to write off God knows how much every single year. However, those "un" negotiated charges will kill those who have no insurance. Therefore, our present health system is indirectly killing people, while sending them to the poor-house.

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Age -57; Diagnosed 10/05 PSA 13.4 GS 9 Organ confined (T2B)

You mentioned

"(1) Loratab 7.5 mg 57.00 (I have gotten 20 10mg at CVS for 10.00)"

That was the No -insurance rate at CVS ?

Part of the cost that is included in the hospital cost is administering the medication. There was no cost for nurses in your breakdown, or cost for countless other people that hospitals need to pay for to help with your care

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Stats:
Age: 52
PSA (2008)=1.9
Biopsy on Jan 09, 2009
One (1) out of twelve (12) cores was positive, plus external nodule found
Gleason Score = 3+3
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, under .0

GImpy, my detailed hospital bills don't break it down that way. The $10 for the whole bottle of loratab at cvs was just their normal generic price.

Also, for some of the other posters above, I am not anti sport or anti movie star or anti rich in general, was just looking at it from a point of view of priorities.

I agree on the EMS workers, sure it varies from area to area, but around here $12.00 pretty typical starting pay.

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Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.

My hospital bill for one night was $45000, but with insurance it was reduced to $4500, huh. this is why everyone needs insurance.  Really I thought all the costs were in line with the insurance adjustment.  The one that seemed high was the anethesoloist, I think he got more than the surgeon.   I think my deal would  have been under 10 grand except I had to pay 5k out of pocket because the surgeon did not take insurance so I had to pay the difference.

Total cost of open surgery $12000 including 5 nights stay haematologist on standby while being operated on (blood problem) over 5hrs in operating theatre 4 doctor visits pre. and port operation but this is the cost in Thailand at their top hospital 

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Age 64 From UK now in Thailand Baby boy born 2/14/2009  First PSA was showing 9.73 on 1/21/09.   on 5/7/09 PSA 9.78  Free PSA 0.83   Free:Total  PSA 0.08  1/28/09 Biopsy carried out 12 core results show no adenocarcinoma 5/15/0924 Core biopsy results Gleason'S Grade 3+2=5 Involving approx 30% of one out of 12 cores on each side no perineural or angiolymphatic invation identified One side PIN High Grade Bone scan clear  Open surgery 7/27/09 Prostate Gland weighting 34 grms Gleason upgraded to 3+3 Tumour not closeto prostatic capsule Seminal Vesicles not involved by Tumour 6 Lymph Nodes negative for Malignant cells

Colin, that is a bargain price by US standards. Hope you be hailing well lately, been wondering about you.

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Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place