Cost of Lumpectomy, Plastic Surgery, Radiaton...

BWH5
BWH5 Member Posts: 56
edited January 2019 in Employment, Insurance, and Other Financial Issues

I would like to have some idea what I will owe after surgery but the numbers I see online vary greatly.

I will probably have a lumpectomy and immediately have oncoplastic surgery and breast reduction on other side. Then 16 rounds of radiation.

Anyone have an estimate of these costs?

Thanks

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  • Salamandra
    Salamandra Member Posts: 1,444
    edited January 2019

    I'm guessing you're in the USA?

    If so, this will depend entirely on your health insurance/coverage. It could be anything, depending on what your insurance has negotiated with the providers, your copays/coinsurance, your deductible, your OOP max, etc. It's really not possible to say without knowing a lot about your insurance.

    Your hospital's financial office should be able to help you get an idea. You can also call your health insurance and see what they can tell you about coverage.




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  • gb2115
    gb2115 Member Posts: 1,894
    edited January 2019

    I met my out of pocket maximum of $4000 from everything, twice because I had the misfortune of being diagnosed late in the year and my treatment spanned two calendar years. So $8000 out of pocket. After that (both years), insurance paid for the rest. That's with a 80/20 PPO United Healthcare plan.

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  • BWH5
    BWH5 Member Posts: 56
    edited January 2019

    thank you both for replies.

    I figured I would not get a definte answer. Just trying to plan for future expenses.

    I do have insurance, in the U.S. I was DX 11/30/18. Could not get surgery done in 2018 unfortunately as we had already met our deductible for the year.

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  • edwards750
    edwards750 Member Posts: 3,761
    edited January 2019

    So you met your deductible but the surgery just couldn’t be scheduled in 2018? That’s unfortunate. Breast cancer expenses span over one year so we had out of pocket expenses too because we had to start over the next year with our deductible.

    We were howeverlucky though that by the time I had radiation -33 treatments - we had met our deductible of $5000. Idk how we would have paid for that too after all the other expenses we incurred. We did have a flex plan that helped although it doesn’t take long to buzz saw through that money either.

    I don’t think you can get a definitive answer about costs because they vary from facility to facility. Suffice to say it won’t be cheap but then it is a necessity.

    Diane



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  • BWH5
    BWH5 Member Posts: 56
    edited January 2019

    Diane

    Thanks for the reply.

    I was DX 11/30/18. I asked them right off if they could do surgery before the end of the year but I believe they could not arrange for the surgeon and the plastic surgeon in a short time frame. I think it was mid Dec by the time I had my two biopsies. I was told they could do a masectomy but I want a lumpectomy.

    My husband had hernia surgery and was also diagnosed in July with CLL leukemia. That is how we met our deductible. I am positive we will this year too.

    I knew I would not be able to get a definite answer. The estimates online were just so crazy. 😃

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  • Salamandra
    Salamandra Member Posts: 1,444
    edited January 2019

    I just got my most recent bill, and also went back and found older ones. Here are some figures. (ia = insurance adjustment, which I think is how much discount off the rate the insurance negotiates - but your insurance could be different from my insurance). This is from MSK in NYC. I

    • Initial meeting with surgical oncologist: charged $975, ia -$337.14
    • Surgery: Lumpectomy (partial mastectomy) $4070, lymph node biopsy $2970, sentinel node dye procedure $1380. Total charged: $8420, ia -$4125.46
    • Pathology for surgery: charged $3265, ia -$393.91
    • Oncotype test: charged $4620, ia: -$467
    • meeting with medical oncologist: Charged $655, ia: -$67.90
    • anesthesiology for lumpectomy (not sure why this came through so much later than the other surgery stuff). Charged: $861, ia: -$299.31
    • EKG: Charged $45, ia: -$11.31
    • Initial meeting with radiation oncologist: Charged $955, ia -$255.68
    • Radiation simulation planning and appointment and devices: charged $2405, ia -$929.46
    • Radiation oncologist dose calculation, device construction, and radiotherapy plan: charged $2230, ia -$473.13
    • Radiation - 5 treatments: charged $900, no ia
    • Radiation - 5 treatments plus device construction (I think this was for the boost): charged $1225, no ia


    I hope this is useful!

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