Uchealth Poudre Valley Hospital
| Self-Pay Price | |||
|---|---|---|---|
| ER | Level 1 Emergency Dept Visit | CPT 99281 | $274 |
| ER | Level 2 Emergency Dept Visit | CPT 99282 | $473 |
| ER | Level 3 Emergency Dept Visit | CPT 99283 | $810 |
| ER | Level 4 Emergency Dept Visit | CPT 99284 | $1,168 |
| ER | Level 5 Emergency Dept Visit | CPT 99285 |
* Price and length-of-stay ranges represent 25th and 75th percentiles. Actual prices may be higher or lower than those listed here.
* Price represents 25th and 75th percentiles. Actual prices may be higher or lower than those listed here.
Questions To Ask Before Financing
Before you finance your surgery, ask these important questions of the lender and of yourself:
- How long will you have to repay the loan?
- What will the payments be on the debt?
- Will you be able to manage the payments or will you be struggling to pay your bills on time?
- Will you be paying your credit cards off forever because you will be unable to make a payment larger than the minimum?
- What will you do if the cost of surgery is higher than estimated by your surgeon?
- Will you be driven into bankruptcy if the cost, and therefore the payments, are underestimated?
- Will you be able to afford the prescription medication you require after surgery if you are paying your credit card bill?
- Will you be unable to save for your future needs if you are paying for your surgery?
What Happens When You Cant Afford To Manage Your Heart Condition
Dr. TianChu Shih is a cardiologist who practices in Lone Tree, Colorado. Like many physicians, she has seen first hand the impact of lack of affordable health coverage and care. She shared with the CCC three stories about patients whose health has been put in jeopardy because of unaffordable healthcare.
While these are true stories of patients Dr. Shih has treated, names and identifying details have been changed to protect patient privacy.
First, Dr. Shih reminds us that health coverage doesnt always mean meaningful access to healthcare. While expanded Medicaid access makes a difference to many Coloradans, network adequacy in the program remains a problem:
We had a wonderful time chatting and completed her physical including a Pap smear.
2 days later, her Pap result came back showing cervical cancer cells. I asked my medical assistant to call Jane and to refer her to our local OB/GYN group. Later on, my MA informed me that he notified Jane, but no OB/GYN locally would accept the referral because she had Medicaid. We couldnt find a single OB/GYN that would see a patient on Medicaid. We had to mail Jane her abnormal PAP result and ask her to call every OB/GYN on her own to find one who would accept her insurance.
I still wake up at night wondering, did Jane have her cervical cancer taken care of? Did this interfere with her nursing schooling?
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The Average Cost For Surgery
Below we outline the out-of-pocket cost for surgeries. The most expensive surgeries are heart valve replacements, heart bypass, and spinal fusion surgeries.
| Surgery | |
|---|---|
| Replace or revise brain shunt | $49,355 |
| Removal of pacemaker or defibrillator | $52,005 |
| Partial removal of the colon | $52,353 |
Borrowing From Retirement Savings
Your 401k or 403b plan for your retirement may allow you to take a loan against the funds that you have already saved without a penalty. These plans differ from employer to employer, but most will allow you to withdraw 50% of your vested balanceup to $50,000for healthcare expenses.
The length of time allowed for repayment varies, but if you leave your place of employment before you repay the money there can be substantial tax penalties. You will lose the interest you would have earned on the money you withdraw, but you will not be paying interest on the loan as you would with traditional borrowing.
If you have a Roth IRA, you may be able to access the funds to pay for your surgery. Typically a Roth IRA is not managed by employers, but by individual investors, so you may have to do your own research. Start by calling the customer service number for your fund and inquire about taking money out of the IRA before retirement age.
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Open Heart Surgery Costs
Open heart surgery can be extremely expensive without Medicare or other insurance.
The Kaiser Family Foundation estimated that the average inpatient cost ranged from $75,688 to $117,000 in 2018 depending on complexity of the surgery and whether there were complications.
Original Medicare does not cover prescription drugs. But you can buy a Medicare Part D prescription drug plan. Most Medicare Advantage plans also include their own Part D plan.
These plans can help with the cost of prescription drugs you will have to take after your surgery, such as blood thinners, blood pressure medications and cholesterol-controlling drugs.
Select Blood Thinner Retail Prices without Medicare or Other Insurance
| Prescription Medication |
|---|
Uchealth Medical Center Of The Rockiesoutpatient Services
| Hospital observation per hr | CPT G0378 | ||
| $34-$138 | |||
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc | CPT 85025 | |
| Comprehen metabolic panel | CPT 80053 | ||
| Various supplies needed for surgery such as instruments, gauze or towels.* | CPT A4649 | ||
| Hydrate IV infusion add-on | CPT 96361 | $161 | |
| LAB CHEMISTRY | Metabolic panel total ca | CPT 80048 | $47 |
| IV THERAPY | Tx/pro/dx inj same drug adon | CPT 96375 | |
| Complete cbc automated | CPT 85027 | ||
| $171 | |||
| IV THERAPY | Ther/proph/diag inj iv push | CPT 96374 | |
| Lipid panel | CPT 80061 | $82-$146 | |
| LAB CHEMISTRY | Assay glucose blood quant | CPT 82947 | $25-$66 |
| LABORATORY | Assay of troponin quant | CPT 84484 | |
| Assay thyroid stim hormone | CPT 84443 | $98 | |
| SUPPLY IMPLANTS | Anchor/screw bn/bn -tis/bn * | CPT C1713 | |
| Therapeutic exercises | CPT 97110 | ||
| Chest X-Ray with 1 view from the front | CPT 71045 | $326 | |
| LAB HEMATOLOGY | Prothrombin time | CPT 85610 | |
| A blood test to diagnose heart failure. | CPT 83880 | ||
| Urinalysis auto w/scope | CPT 81001 | ||
| A thin wire used to guide a catheter or other device into place.* | CPT C1769 | ||
| Ther/proph/diag inj sc/im | CPT 96372 | ||
| Flowcytometry/tc add-on | CPT 88185 | ||
| CT abd and pelv w/contrast | CPT 74177 | $4,009 |
* Price represents 25th and 75th percentiles. Actual prices may be higher or lower than those listed here.
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How Much Is A Medical Visit Without Insurance
The average visit to a healthcare professional in the U.S. in 2016 cost $265.
This average, though, depends on the type of provider youre visiting, and the type of appointment.
For example, an average visit to a primary care provider cost $186, while a visit to a cardiologist was $335.
People with insurance usually have something called a copay, meaning the amount youll owe out-of-pocket before your insurance picks up the remainder of the tab.
The average copay rates range from $25 to $50 for most plans and services. Even for minor issues, its a huge help to have insurance in some form.
How Can I Get Surgery Without Insurance
In case youre considering how to get a medical procedure without any insurance, then there is some uplifting news for you that a few clinics may offer installment plans. The most ideal approach to deal with this is by asking the clinics charging division about this before your surgery, however this may not generally be conceivable in the event that your surgery is being performed in an emergency. In such cases, the medical clinic might need to work with you to build up an installment intended to take care of the expenses. Its critical to address this when youre ready so that the medical clinics charging division knows that another installment choice has been set up for you. This will forestall any issues down the line, for example, the association of an assortment organization.
In addition to this, there are also some more ways as to how you can find help to pay for your surgery in case you do not have insurance. Let us look at these ways now:
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Are There Free Surgeries
Some operations and visits are completely free if you have insurance, besides the discount you receive for simply having one. You read that correctly: Theyre free. As part of the broader category of preventive care, these procedures are now available to everyone with health insurance thanks to the Affordable Care Act.
To give you an idea of how much you could have to pay for these otherwise free services:
At your local Rite-Aid drugstore, you can get a flu shot for roughly $40.
- Diabetes and cholesterol screenings are available for roughly $125 to $200 at CityMD urgent care clinics in New York, New Jersey, and Washington, DC, with additional lab fees.
- According to a John Hopkins research, the average cost of annual wellness visits is $160.
- According to Planned Parenthood, youll need two doses of the HPV vaccine, which costs around $250 each time.
- Pills for contraception: A years worth of monthly packs will cost anywhere from $240 to $600.
The Cost Of Surgery Without Insurance
Paying for surgery out of pocket can vary greatly, costing you between $4,000 and $170,000, depending on what surgery you get. LASIK eye surgery may cost you about $4,000 because the surgery is less intensive, takes less time to perform, and can be an outpatient procedure, which is less expensive when compared to inpatient procedures.
However, more extensive surgeries such as a heart valve replacement or heart bypass are more expensive for the following reasons:
- Pre and post-operative hospital stay. Before and after receiving surgery, you will likely have to stay in the hospital. This is to make sure you are prepared for the surgery and are recovering well after. The average hospital stay is 6-7 days for bypass surgery.
- Pre-surgical treatment. Pre-surgical treatment is done to increase the success of the surgery this may include catheterization and other treatments necessary to ensure that bypass surgery is successful.
- Anti-rejection medication. Anti-rejection medicine is necessary to prevent your body from rejecting any new organs, arteries, or valves after surgery. It may be prescribed for transplant surgeries as well.
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Helpful Ways To Get Surgery Assistance
The cost of some medical procedures can add insult to injury. Even if you have health insurance, pre-deductible and out-of-pocket costs can quickly add up. When you add these expenses to lost wages during recovery, the total medical bill can be overwhelming. If youre wondering how to get help paying for surgery, look to the four resources below for help getting surgery assistance.
Using Retirement Funds As Security For A Loan
You may be able to take out a loan from your 401k or 403b retirement plan without incurring a penalty. In most cases, you can take out half your vested balanceup to $50,000for healthcare expenses under these plans.
You might incur tax penalties if you leave your job before repaying the money you borrowed, regardless of the length of the payback period. Taking money out of your account will result in interest being deducted from your account, unlike traditional borrowing.
Individual investors, not employers, typically administer Roth IRAs, so youll likely have to do some digging of your own. If you want to know the cost of surgery without insurance, read our FAQ section.
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Paying For Hospital Stays And Surgeries
In 2019, Medicare spent about $799.4-billion on benefit expenses for 61-million individuals who were age 65 or older or disabled, according to the U.S. Department of Health and Human Services. Inpatient hospital services accounted for 29% of that amount . Approximately 36.3-million patients per year are admitted to U.S. hospitals, according to the American Hospital Association, and Medicare pays 90% of the costs for almost 42% of them. Overall, Medicare payments account for nearly 20% of all hospital care costs.
In 2019, Medicaid paid about $138.7billion for acute-care services, such as hospital care, physician services and prescription drugs. Its share of hospital admissions is about 20%, for whom it pays about 89% of all hospital costs. Overall, Medicaid pays for approximately 17% of all hospital care costs.
There are other ways to pay for surgery. Private health insurance pays for approximately 34% of all hospital care. Out-of-pocket costs comprise 11% of the total, while 18% are covered by other sources, including all other public health insurance programs, such as the Childrens Health Insurance Program , and programs of the Department of Veterans Affairs and the Department of Defense and other third-party payers, including workers compensation, and other state and local programs.
In the best-case scenario, the patient will have primary insurance to pay most of the expenses, along with a secondary form of insurance that pays the remaining expenses.
Uninsured And Facing An Emergency Know Your Rights
Just because you dont have health insurance does not mean youre without protection. Know your rights.
As an uninsured individual, you may not be familiar with what rights are available to you in an emergency. You have the right to emergency care if you meet the federal guidelines of what constitutes an emergency situation.
So what qualifies as an emergency?
- Any incident that is severe or life-threatening,
- Any incident where bodily functions or organs are seriously impaired,
- Any incident where delivery is imminent in a pregnant woman.
No matter what your insurance status, hospitals and emergencies room must provide adequate care if your situation qualifies as an emergency.
Some visits will not qualify under the formal definition of an emergency:
- Going to an emergency room for non-life threatening care
- Visiting an urgent care facility for non-life threatening events
- Prenatal care, wellness checks, screenings, follow-up appointments or ongoing doctor visits
- Situations that are not considered life threatening, like flu, colds, rashes, etc.
Once your immediate situation has been assessed and you have been stabilized, your hospital may elect to transfer or discharge you.
Please keep in mind just because you go to the emergency room, it does not mean you will be seen if your situation does not constitute an emergency.
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Make Plans For Alternate Methods
If your health insurance and Medicare alternatives have been explored, it may be time to look into other options for paying for your surgery. Remember that, unlike insurance, which covers most of the price, all financing solutions require the funds to be repaid.
Also, make sure that the costs youre financing include all anticipated expenses, such as the surgeons bill, the cost of the operation theatre, anesthesia costs, medical care before and after surgical procedure, labs, medications, X-rays, and any other testing your doctor orders, as well as any required visits before and after the surgery. Also, before you have the operation, be sure you know what your post-surgery payments will be. You dont want to be surprised when your first bill arrives with a much larger interest rate or payment than you anticipated. Youll also need to budget for any unexpected costs, like problems, which might considerably increase the entire cost of your care.
Uchealth Billing And Pricing
| Hospital observation per hr | CPT G0378 | ||
| Various supplies needed for surgery such as instruments, gauze or towels.* | CPT A4649 | $187-$794 | |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc | CPT 85025 | $89-$95 |
| SUPPLY IMPLANTS | Anchor/screw bn/bn -tis/bn * | CPT C1713 | |
| Hydrate IV infusion add-on | CPT 96361 | ||
| $9-$80 | |||
| LAB CHEMISTRY | Metabolic panel total ca | CPT 80048 | |
| Comprehen metabolic panel | CPT 80053 | $243-$258 | |
| IV THERAPY | Tx/pro/dx inj same drug adon | CPT 96375 | |
| $237-$290 | |||
| IV THERAPY | Ther/proph/diag inj iv push | CPT 96374 | $150 |
| LAB CHEMISTRY | Assay glucose blood quant | CPT 82947 | $50-$59 |
| LABORATORY | Assay of troponin quant | CPT 84484 | |
| Urinalysis auto w/scope | CPT 81001 | ||
| CT abd and pelv w/contrast | CPT 74177 | ||
| $84 | |||
| IV THERAPY | Tx/pro/dx inj same drug adon | CPT 96376 | |
| Therapeutic activities | CPT 97530 | ||
| Chest X-Ray with 1 view from the front | CPT 71045 | ||
| Assay of lipase | CPT 83690 | ||
| Complete cbc automated | CPT 85027 | ||
| Assay thyroid stim hormone | CPT 84443 | ||
| Various instruments needed for surgery such as scissors or clamps. | CPT A4550 | $339-$1,302 | |
| LAB HEMATOLOGY | Prothrombin time | CPT 85610 | $17-$62 |
| ADMIN VACCINE | Monoclonal antibodies given to someone with mild to moderate COVID illness and is at high risk of it becoming severe or needing to be in the hospital. | CPT M0243 | $393 |
* Price represents 25th and 75th percentiles. Actual prices may be higher or lower than those listed here.
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Need To Go To The Doctor But Have No Insurance
Modern medicine can treat almost every affliction, from a broken bone to COVID-19 to major depression. But those treatments can be exorbitantly expensive.
If youre one of the 8 percent of Americans with no health insurance or if youre worried that you dont have the money to pay for the care you need, you may feel locked out of the healthcare system.
It can be confusing, scary, and stressful: Two-thirds of Americans worry about affording their medical bills.
If you dont have insurance, can you get the care you need when you need it? Yes.
While its challenging to navigate the medical world without health insurance, its not impossible to get affordable care for yourself and your family, even if you dont have money to afford a private plan.
In this article, Ill help you understand your care options if you dont have insurance and are worried about money. Ill talk about how much you can expect to pay for a healthcare visit if you dont have insurance.
Ill provide advice on what to do if you have a medical emergency, and tell you if providers can refuse you treatment.
Finally, Ill provide some tips for making healthcare more affordable when you dont have insurance.
With K Health, you can get the help you need from anywhere. Faster, easier and more affordable than urgent care.