Page 1 of 1
Prosthesis cost
Posted: Fri Mar 08, 2024 4:25 pm
by Stayingstrong
Does anyone know exactly what the Coloplast and AMS units cost and does the doctor or insurance company foot the bill for the prosthesis?
Re: Prosthesis cost
Posted: Fri Mar 08, 2024 4:46 pm
by Jage64
I've been told the AMS unit is ~$700 more than the Coloplast, but I don't know the base cost. I think in some situations that may be why a particular doctor may only offer the Coloplast, there's more profit in it. AMS has a very significant worldwide market share advantage over Coloplast, so I assume the lower cost by Coloplast is to try to cut into that market share.
My doctor doesn't change the price based on which implant is used, he'll help guide you to the best option for your anatomy and need based on factors other than profit. I'm convinced that the Coloplast product is of comparable quality to the AMS, but they do have noticeable advantages and disadvantages to each, depending on the penis and the manner in which it'll be used.
You can imagine, if a doctor does a couple implants a week, that could be a $70,000 difference in the bottom line at the end of the year.
If you pay out of pocket, as I did, I PAID for the implant. Otherwise the insurance company will pay. At no time does a doctor pay for it, it's either the patient (in the fee charged) or the insurance company.
Re: Prosthesis cost
Posted: Fri Mar 08, 2024 4:52 pm
by Txagq8
This is a pretty difficult question to answer.
Like everything else associated with medical care, the correct answer is “it depends.”
If you turned back the clock before government got involved with healthcare delivery, an office call might be $4 or $5. A device like a 3 piece implant hadn’t been invented, but something like it would have been a couple hundred bucks.
Then the government got involved. Medicare/Medicaid would set allowances for what doctors would get paid. To compensate, they raised what they would bill. Insurance carriers would negotiate what they would pay for various procedures and disallow other procedures. It’s why some group insurance plans won’t cover an implant if you’re a guy with ED, but will if you’re a female transgender transitioning to male. Don’t get me started.
Talking to guys on here, medical professionals, etc: here’s what I come up with.
Hospital/Surgeon/AMS or Coloplast/Anesthesiologists are going to bill between $45K and $55K for this procedure to include the device, unless you’re self-pay-with-money in which case you’re looking at between $18K and $23K. The device itself is going to end up being reimbursed at between $8K and $10K.
I guess you could call and tell AMS or Coloplast to ship you one out, you’re gonna do a self-install….but I don’t think they’d take you seriously.
I’m guessing a doc aligned with AMS or Coloplast is probably able to offer a better cash price for self pay patients since he encourages the use of a specific brand.
So call a new implant, out of the box $8500, maybe $9000 real price. Regardless of what might show up as MSRP on a hospital bill. Of course, you could probably get a deal on a used one they’ve had to yank out of someone during a revision.
It’s kind of surprising you don’t see anyone advertising previously owned/factory reconditioned implants…
Re: Prosthesis cost
Posted: Fri Mar 08, 2024 4:55 pm
by Stayingstrong
"If yoo u pay out of pocket, as I did, I PAID for the implant. Otherwise the insurance company will pay. At no time does a doctor pay for it, it's either the patient (in the fee charged) or the insurance company."
At that rate, with the insurance company paying for the unit or the patient paying for the unit, the doctor really has no financial benefit by using a lesser expensive implant?
Re: Prosthesis cost
Posted: Fri Mar 08, 2024 9:25 pm
by Jage64
Patient paying they for sure make the money.
Re: Prosthesis cost
Posted: Sat Mar 09, 2024 9:55 am
by JetAirliner
The implant “acquisition “ cost to either a high volume Surgery Center or Hospital is generally $4,000 - $5,000 and is usually marked up 3-4 times when sent to the insurance company …The Insurance Company is already going to have a negotiated rate that they will pay based on the plan coverage… High volume Surgery Centers and Hospitals will negotiate Volume contracts based on usage very similar to how both Orthopedic Implants and Intraocular lens implant are negotiated.. The more you use - the better the price
Re: Prosthesis cost
Posted: Sat Mar 09, 2024 1:21 pm
by whynotme
i got extremally lucky and was expecting a 20 to 25k bill in jan when i had my implant done in london ontario ( i never asked as there is no sence being the richest person in the grave yard ).
but it was only after my surgery (AND i found out here in an old post) that london is a fully funded cost hospitol for the proceedure
Re: Prosthesis cost
Posted: Sun Mar 10, 2024 1:49 pm
by Bigdog4all
I received my detail billing of my Bionic Implant. It was something that I would have never laid out the actual cash for. It was all covered by my insurance. They broke down the costs from the actual device to my pain pills, and all in-between. I'm sure there is mark-up $$$$$ in the entire billing.....but for FYI.....Came in at around $83,000 +, in detail. I can't wait to test drive this car.
Re: Prosthesis cost
Posted: Sun Mar 10, 2024 4:43 pm
by easymoney
My Rigicon totaled out at about 92k last June in Tampa.