Anyone know what is cost of 3 piece if self pay

The final frontier. Deciding when, if and how.
oldbeek
Posts: 2547
Joined: Sun Sep 10, 2017 1:46 pm
Location: Los Angeles area

Re: Anyone know what is cost of 3 piece if self pay

Postby oldbeek » Sun Feb 09, 2020 11:10 pm

I saw a discussion about ED and a dr in Canada made the statement that an implant would cost public health $11 to $12, 000.00. Don't know if his statement was just off hand or fact.
82, good health, RP 7-2017, all nerves taken , PSA 0.05, 4-18,, .07 1/19,.05 4/19, .03 11-21, .04 11-23, implanted 4-1-18, Infra-pubic, AMS lgx 15 cm with 5cm rte. Implant at USC Keck. Dr Boyd and Dr Loh Doyle 6.5 x 5, 800 AUS 7-21-20

Txagq8
Posts: 885
Joined: Tue Oct 01, 2019 4:41 pm
Location: Texas Hill Country

Re: Anyone know what is cost of 3 piece if self pay

Postby Txagq8 » Mon Feb 10, 2020 3:56 pm

Just got off from insurance carrier, my bill has been settled.

The hospital billed $53K. They took $15K.
The surgeon billed $1800. He got paid $1300 iirc.
Each anesthesiologist (there were two) billed $1305, together they got $190.
There was some other misc charges that brought the whole thing up to just over $17K.
I have an unpaid balance for out of pocket in the amount of $2.84.

So guys, if you’re trying to negotiate an out of pocket deal based on what negotiated prices between hospitals and insurance carriers are really like, $17K would be a good place to start.
Age 68. Physically fit educated red neck in Texas. Very married. 23 cm (18+5) of LGX installed by Dr. Bryan Kansas 12/31/2019. I fought the ED and my wife & I won. I’m either full of shit or sound advice. You decide which.

Waynetho
Posts: 1768
Joined: Wed Nov 27, 2019 11:22 pm
Location: Dallas, TX

Re: Anyone know what is cost of 3 piece if self pay

Postby Waynetho » Mon Feb 10, 2020 5:45 pm

I just pulled it BCBS explanation of benefits for my surgery:

Code: Select all

Hospital  53,577.20 billed  34,485.77 paid
Surgery    3,875.00 billed   1,022.26 paid
Surg asst  1,937.50 billed     163.56 paid
Anesthesia 3,132.00 billed   1,322.10 paid
PA           370.80 billed     153.74 paid
------------------------------------------
Total     62,892.50 billed  37,147.43 paid
62yo, married 41 yrs. Urolift (x4) 8/12/19. AMS 700CX 15cm (no RTE) penoscrotal 10/28/19, Frisco, TX. PD 1995/ED 2011. Cialis helped but hinged. (1995)L:6/G:5.5+, (2019)Pre-op L:5/G:4.5, (2/2020)L:6.0/G:5.0

Biker60
Posts: 362
Joined: Sat Aug 03, 2019 12:06 am
Location: Philadelphia Pa

Re: Anyone know what is cost of 3 piece if self pay

Postby Biker60 » Tue Feb 11, 2020 5:00 am

Hospital charges 87k plus 6700 for surgeon. Aetna rate 43k since they paid for a plication. Hospital coded as Ed, and declined paying for implants. Hospital charge to me is 43k plus $500 copay. Exclusion for sexual dysfunction, no consideration for Peyronie’s. Drs office sent billing office updated dx codes. I already filed 1st appeal I have 3 more appeals if it gets that far. Told business office that they already screwed up my first appeal because of coding wrong. Told them not to hold breath, I am noting paying anything til it’s corrected. Decision on 1st appeal is due by 2/20. But I would settle for Medicare rate. My employer is the last appeal. Five hospital system that excludes implant for sexual enhancement. But they paid 40K for xiaflex injections. They also will cover implants for gender reassignment. Can’t complain about breast implants because that is a federal mandate.

lettherebecure
Posts: 3
Joined: Sat Nov 18, 2017 9:10 am

Re: Anyone know what is cost of 3 piece if self pay

Postby lettherebecure » Wed Feb 12, 2020 1:53 pm

Anyone know what is the price of a revision out of pocket?

igotquestions
Posts: 38
Joined: Mon Nov 11, 2019 6:00 pm

Re: Anyone know what is cost of 3 piece if self pay

Postby igotquestions » Wed Feb 12, 2020 2:06 pm

iam from germany and eventually look to get surgery done by dr.kramer.

in the old list his price is 24.000$, is that everything included or will there be more costs?
31yo, german, ed since i was 14 old after a sports accident. implanted with model AMS700 11.11.2022 by Dr.Osmonov in Germany.

544kenmatt
Posts: 221
Joined: Sun Nov 17, 2019 10:17 am
Location: ROCHESTER , NY

Re: Anyone know what is cost of 3 piece if self pay

Postby 544kenmatt » Wed Feb 12, 2020 4:52 pm

I know the insurance contracted price in Rochester, NY was around $19,000. Perhaps you could negotiate with your provider to charge you the insurance approved amount. That price included everything.
AMS 700 LGX 10/31/2019. age 63

andrew1959nj
Posts: 271
Joined: Thu Jun 14, 2018 3:04 pm

Re: Anyone know what is cost of 3 piece if self pay

Postby andrew1959nj » Wed Feb 12, 2020 4:58 pm

I'm in NJ, my doctor who I have used for 10 years had a fixed price paid upfront of $6,000, plus the device $12,000 plus the surgery center and anesthesiologist or hospital.
60 years old. MS and Severe ED 10+ years. Pills and injections never worked well. Implanted 5/16/2019 by Dr. Sadeghi. Titan 20cm + 2cm RTE.


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