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How Much Does It Cost

By Joan Gonzalez,2014-11-13 14:05
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How Much Does It Cost

    How Much Does It Cost?

    What does your health care cost? Your office copay may be $15 or $20, but that’s just a

    sliver of what it actually costs to provide the care. Here’s a sample of common medical

    treatments and the average charge from hospitals or clinics. These are the charges

    prior to any discounts negotiated by a health plan or insurer and are calculated using

    2003 charges.

Medical Treatment Description Cost

    A common cold, You feel rotten, go to the doctor and are told to go $80

    office visit home, get plenty of rest and drink fluids.

    A common cold, ER You feel rotten, and instead of going to your clinic $181

    visit during the day, you wait until midnight and go to the

    ER.

    Sore throat, office Your throat hurts, you go to the doctor. Price includes $109

    visit visit with physician and Strep test. Test was negative.

    Sore throat, ER visit It’s the middle of the night and your throat really hurts. $406

    You decide to go the emergency room. Includes ER

    charges and test for Strep. The test was negative.

    Ear ache, office visit Your 2-year-old daughter is pulling on her ear. You go $78

    to the clinic. Office visit and exam. No infection is

    diagnosed.

    Ear ache, Urgent Your 2-year-old daughter is pulling on her ear. You go $111

    Care visit to Urgent Care. Visit and exam. No infection is

    diagnosed.

    Ear ache, ER visit Your 2-year-old daughter is pulling on her ear. You go $151

    to the emergency room. ER visit and exam. No

    infection is diagnosed.

    Tubes in ears Your child has had chronic ear infections. The decision $2,719

    is made to insert tubes his ears. Price includes office

    visit 30 days before procedure and 30 days after, day

    surgery charges, antibiotics, drops and decongestants.

    Diabetes check-up You have been diabetic for six years and your $535

    diabetes treatment has been going well. This is your

    annual trip to the clinic to see the doctor for a diabetes

    checkup, including cholesterol and blood sugars

    (HbA1c) checks.

    Chest X-ray You go to the clinic with a bad cough. Your physician $183

    thinks it may be pneumonia and orders a set of X-rays

    to help make the diagnosis. Price includes clinic visit,

    X-ray and reading of the results.

    Diagnosis and The prevalence of sexually transmitted diseases is a $215

    treatment of public health concern. This price includes an office

    Gonorrhea visit, test and treatment of Gonorrhea with an antibiotic

    injection or oral antibiotic.

    Allergy shots You have been diagnosed with allergies and go to the $64

    clinic each week for a shot. The visit does not include

    seeing a doctor.

Medical Treatment Description Cost

    Colonoscopy Full, flexible colon scope test conducted by specialist $1,985

    on an outpatient basis. Includes test and reading of

    the results.

    GI Endoscopy Conducted by a specialist. Scope exam of the gastro-$1,398

    intestinal track on an outpatient basis. Includes

    conducting the test and reading the results.

    Skin cancer A black, purple odd shaped mark on your arm requires $1,533

    diagnosis a consultation with a specialist, biopsy and removal of

    skin lesion.

    Stress test Your primary care doctor orders a stress test. This $1,885

    price includes a trip to the specialist, administering

    test, reading results.

    Eye exam Exam by ophthalmologist. $176

    Allergic reaction to a Price includes the ER visit and diagnosis, in addition to $1,050

    bee sting drugs to treat allergic reaction. Treatment could also

    include a hospital stay for a severe reaction.

    Broken ankle You broke your ankle playing soccer. Includes trip to $1,386

    the ER, X-ray of ankle and applying short leg cast.

    Step on a rusty nail You step on a nail while taking a walk. Price includes $1,030

    laceration on foot, ER fee, repair, tetanus shot or

    antibiotics if needed.

    Broken arm Your child jumped off the swing set. Price includes ER $2,523

    visit, X-ray, simple cast.

    Tonsillectomy Your child (under 12) needs her tonsils removed. This $4,875

    price includes a pre-surgical office visit, surgery at a

    one-day surgery and any related post surgical visits

    with in 30 days.

    Frostbite treatment Your child loses her mitten on one of the coldest days $321

    for a hand of the year. You make an urgent care office or ER

    visit. The price includes diagnosis and treatment and

    excludes critical cases.

    Diagnose mono Your teenager is run down, extremely tired. A trip to $152

    the clinic and Heterophile antibodies test shows mono.

    Therapy session You see a licensed therapist. Does not include $152

    prescriptions drugs or psychiatrist evaluation.

    Outpatient chemical You attend 21 to 30 days of alcohol- or drug-related $4,487

    dependency chemical dependency counseling through a hospital’s

    treatment outpatient program.

    Cut on the hand You’re using that new knife and you slice into the $3,066

    tendon in your hand. Price includes an ER visit,

    complicated stitches, tetanus shot if needed.

    PAP test Woman of childbearing age, includes exam by $229

    gynecologist, test and reading of results.

    Routine Women 35 and older, includes the test and reading of $125

    mammogram results.

    Medical Treatment Description Cost Prostate cancer Includes office visit for man age 50 or older, blood $285 screening test (PSA) draw and PSA test.

    Having a baby Price is based on “perfect” pregnancy, including $8,751

    routine prenatal costs, no risk factors to mother,

    uncomplicated vaginal birth.

    Hysterectomy Simple hysterectomy, not caused by trauma, cancer, $21,686

    etc. Includes physician charges, hospital surgical and

    room and board charges and follow-up visit.

    General physical, Well-baby check $134 charges vary by age: Age 5 to16 $232 Exam of a person in Age 18 to 39 $302 good health. Simply a Age 40 to 64 $371 physical, not a problem-Age 65 and older $323 focused clinic visit.

    Prescription Drugs 2005 Average Wholesale Price. Prices show difference between a prescription drug co-

    pay of $25, for example, and the retail price of the drugs received. Prices are based on

    common dosages for co-pay arrangements.

    Drug Description Cost Ortho-Novum 84, 1/35 tablet birth control pill, (standard three-month $141

    prescription with one co-pay).

    Prozac 30, 20 mg capsules, used to treat depression. $129 Generic for Prozac 30, 20 mg capsules $32 fluoxetine

    Zyrtec 30, 10 mg tablets used to treat allergies. $70 Lipitor 30, 20 mg tablets used to treat high cholesterol $114 Adderall 60, 20 mg tablets. Used to treat ADD/ADHD. $179 Generic for Adderall, 60, 20 mg. tablets. $82 D-amphetamine

    Ritalin 100, 10 mg tablets used to treat ADD/ADHD. $94 Generic for Ritalin, 100, 10 mg. tablets. $38 Methylphendidate

    Concerta 60, 18 mg tablets used to treat ADD/ADHD. $182

    Source: Minnesota Council of Health Plans, 2005. This document reflects Minnesota health plan commercial and government programs data, analyzed by

    Data Intelligence, LLC.

    For information, contact: Eileen Smith smith@mnhealthplans.org; 651-645-0099 x 11

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