Topic: Unbelievable Nipple Cost!!!

WOW~  That's more than my whole Mast and sln bx costs, I think!  WHEWEeeee~ What hospital in what town? 

Urbie, I had one nip done and received a bill from the hospital for $8000-something....can't remember the exact amount but it was staggering and that wasn't for the PS, just the hospital.  I had light sedation but was in an OR.  I called the hospital and told them they would have to re-po my nip because I wasn't paying it.  They told me to calll the PS who recoded it and it was finally paid by my insurance.  It sounds like you've already done the phone calling so I don't think my story will be helpful.  Just wanted to commiserate with you on the $$$$$$$$$$$$$$$$$.  I hope you get it resolved.  Best wishes

$9000 for nipple reconstruction???  That is insane!  It has to be a coding mistake somewhere.  I was in the hospital for 4 days when the doc had to clean out my chest where the expander was (bad infection).  The stay included surgery, 2 days on the cardiac unit and all the other bells and whistles.  The total cost for that stay was just over $12,000.  Something is very wrong with your bill. 

I had a hospital stay miscoded once (for my daughter).  I had a terrible time correcting it, but my insurance company sent for the records and determined it to be a coding error and I didn't have to pay anything.  Try talking to your insurance company.  They must have a department that deal with disputing charges.  Good luck.

Look in your insurance book. Insurance covers all of the recon fees as long as it has a breast cancer diagnoisis.

when I was looking at alternative nipple methods, I got an opinion from a doc in NYC.  He charges $9000 for just the nipples- includes everything including tatoo.  He does not take insurance and wanted 1/2 upfront just to schedule surgery.

I went with my PS who does supmit to insurance and takes whatever they give him.  I had no out of pocket.

So.... your price may not be high in NYC prices!

Good Luck

Susan

The cost of surgery is crazy... I just had one breast done and just at the expanding stage and my bills they have submitted to the insurance company are already over $75,000.  I'm just thankful I have insurance

Some good news I found out Friday.  I had got an explanation of benefit saying my insurance won't pay any of my oncotype test which was over $3,600.  When I called the oncotype people they said they are working on an appeal for me than she asked if I talked to anybody about assistance if the insurance won't pay it.  She shared that if your gross income on your taxes is less than appox. $84,000 I won't have to pay a penny of it.  That was such good news  .  Although I must admit I sure wished we made more than $84,000 

Urbie: Don't feel too bad. I have no idea what my nipples will cost, as I changed PS.

The hospital bill for the exchange was over $40,000!. My PS changed about the same but I am not sure what his figure covered, as it was not itemized. It may have included the price of the fills and 2 surgeries her performed during that time to remove and clean out infections.  However that billing did not include his part of the mastdectomy - placement of the expanders.

I believe my new PS is even more expensive, as no one can enter his private office "building" without being buzzed in. The joy of having medical procedures in Beverly Hills.  

Miles,

I just had my stage II and had lipo to hips, flanks and abdomen and insurance covered it.  I have a great PS!   I didn't go to NOLA and was hesitant to ask about lipo, but I sure am glad I did.  Then before my surgery my PS was marking me and I asked him to do as much as he could.  You have nothing to lose by asking!

Don't know if you already have this info., but check out www.plasticsurgery.org.  Scroll down to 'How much will breast reconstruction cost?', related links, ASPS recommended Ins. coverage.  It talks about law and insurance companies not being allowed to pay less coverage and other requirements. 

I'm sure you already know, but there are state and federal laws governing insurance coverage for breast reconstruction including nipple procedures.  Good luck. 

Well I called the medical center - University of Virginia Medical Center in Charlottesville, VA - and they sent it to a review board and say that it was coded correctly.  I have asked them for a detailed printout of all of the costs incurred so I can take it to the media.  Do you think that The Today Show would be interested in doing a story about the OUTRAGEOUS costs of breast reconstruction? 

I could actually see it if this was a real surgery, but cutting a few flaps of skin and sewing them together to create two small bumps and charging almost $10,000 for it?  Come on.  It is insane

Don't forget - the $9K is the "list price".

Nobody pays that. The "Contractual" price was about half. 

It doesn't seem unreasonable to me, given that these things cost a fortune.

Your co-pay of $2,500 seems high, but that would well be your insurance.   We pay $100 for outpatient surgery, but they've been sneaking a bunch of other little charges in on that. 

I just had this conversation today with a colleague over at the ASPS.  There are no guidelines for the cost of breast reconstruction due to the way insurance is in America. 

I am really surprised that nipple reconstruction is not included in your breast reconstruction.  It truly baffles me.

I would absolutely seek out news media-- they love to bring attention to things like this...

I'm paying close attention to all of this advice as I will be getting it done later this year! 

Urbie you might also want to contact Good Morning America (ABC). Robin Roberts, co-anchor, was diagnosed last year with breast cancer.  

I just had my nipples done in April.  Due to the guidelines in my insurance plan (I have Empire with a Cancer Resources rider on the policy)They billed out $6700. 

Hi Urbie!  My nipple recons came to a little over  $14,000!!!    My advice is to call the insurance commissioner in your area and see if he or she can help.  Good luck to you !