How much am I looking at for my Needle Biopsy

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maggs3
maggs3 Member Posts: 27
edited February 2018 in Not Diagnosed But Worried

Just another thing to worry about....

I work part-time and I'm on SSDI, I have Blue Chip. It pays 80% of the cost of the biopsy. I was told if I go to an Imaging Cernter which I am, but it's part of a hospital, it's a Women's Breast Center, it will be less than if I have surgery. But, then there's the numbing agent right? The Pathologist that gets paid? Am I looking at something like $5,000?? At 20% that is still a lot of money? So, the stress just keeps on building and building... What is the average cost that I can be looking at for this?

Thanks!!!! (Maybe I need to start buying lottery tickets)!!

Comments

  • djmammo
    djmammo Member Posts: 2,939
    edited February 2018

    maggs3

    In general there will be separate bills from the facility (hospital etc) for materials and technical help and from the physicians involved (radiologist, pathologist etc) for performing the procedure.

    CLICK HERE: This is a good place to start looking for a ball park costs

  • gb2115
    gb2115 Member Posts: 1,894
    edited February 2018

    I had insurance pick up a lot of my biopsy costs, but the core needle biopsy cost wasn't bad (I have a 20% coinsurance too). Maybe a few hundred dollars out of pocket. It couldn't have been more than $500, I think actually way less. This was at a breast center inside a hospital. My MRI biopsy was a different story, that was over $1000 because the insurance considered part of it "experimental" and wouldn't fully cover, insinuating that I should have known what type of MRI it was and should have requested to not have "experimental" technology used. As if someone in the middle of a cancer diagnosis would know about that first of all and second of all put it all together during a moment of personal crisis. Right. It still makes me mad to think about it.

    Anyway, that's neither here nor there. For the biopsy, I remember I had bills for the radiologist, the "surgical" procedure, and then for the mammogram they do afterwards to make sure the clip marker is in the right place. I don't remember getting a pathology bill. I think my insurance paid that in full.


  • djmammo
    djmammo Member Posts: 2,939
    edited February 2018

    gb2115

    "...insinuating that I should have known what type of MRI it was and should have requested to not have "experimental" technology used."

    Unfortunately many insurance companies will deny an MRI with the excuse "experimental" for many different standard MRI exams which is fiction and purely an attempt to save the ins company money.

    They did this when CT scanning began in 1975. Was called "experimental" for far too long and now it is standard of care for almost every ailment as MRI has become for breast, spine, and so many other organs.

    Trust me there was no "experimental vs non-experimental" MRI for you to have chosen between.

  • Hopeful82014
    Hopeful82014 Member Posts: 3,480
    edited February 2018

    Maggs, I can't help you estimate what your 20% will be - that's so variable. However, I can give you a couple of tips for paying the various providers:

    1) Facilities such as hospitals will SOMETIMES give you a discount if you pay the bill in full. They usually won't tell you this upfront - you have to ASK.

    2) If you can't pay it in full talk with the provider or facility and see what you can work out. Sometimes they will agree to reduce the charges and/or set up a payment plan.

    3) Talk with a social worker at the hospital - they may be able to help you navigate the costs and payment issues. They may also be able to connect you to organizations that can help financially.

    Don't let the financial aspects contribute too much stress to this situation - just keep reminding yourself that there are resources. Good luck. I hope it turns out benign.

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