How much does prostate surgery cost in the US?

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KJN
KJN Member Posts: 6
edited March 2014 in Prostate Cancer #1
I am a 52 year-old American working in Japan, recently married, just diagnosed with prostate cancer. My PSA is 6, Gleason score is 6, pattern 3+3. I have been following this forum since my first high PSA results last July. I appreciate all the great information, honesty, and compassion.

Two urologist surgeons in Japan told me that at my age, I should go back to the US if I want nerve-sparing surgery done. In Japan, it is still new. I am considering returning to the United States to have a da Vinci robotic, or laparascopic, prostatectomy done. I am wondering if I can afford it.

Question: Can anyone give me a general idea of how much either one of these surgeries might cost “out the door”, including all the hospital, doctor, and anesthesiologist’s fees? I need to get an idea if this is even remotely possible for me. I may get little, or no, reimbursement from my overseas medical insurance.

KJN
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Comments

  • randy_in_indy
    randy_in_indy Member Posts: 496 Member
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    KJN - Robotic Surgery Cost
    I have only recieved my Hospital bill (which to me was rediculous) $26,015.00 Some of the rediculous line items:

    Pharmacy Services $1,876.25
    Supplies = $2,655.50

    I would imagine my Surgeon Teams bill will be about the same amount or slightly less putting it at $40,000 to $50,000. I had mine done in Carmel Indiana heartland of america...should be way cheaper than east or west coast.

    I'll report my surgeons bill once received.

    Randy in Indy
  • 142
    142 Member Posts: 169
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    DaVinci cost as billed
    I went back and added up all of the original "billed" amounts from all of the doctors, hospitals, and labs involved. This has nothing to do with what insurance paid, nor any negotiating one might do before going in.
    This starts with the exam where they found the high PSA, includes the 12 sample biopsy, second opinion from the radiation oncologist, CT & Bone scans, two brief physicals to be sure I could undergo surgery, flu & pneumonia vaccinations to be sure I didn't get sick enough to have to reschedule surgery.
    Then DaVinci surgery, 4 days in the hospital, followups.
    I hope all the bills have arrived, but no promises.
    There is no consideration for any of the non-Rx stuff to get the house ready, travel, hotels, etc.
    I am 12 weeks out as of yesterday. My stats are very similar to yours, They are in my profile.
    $66,157.30 USD
    Now, as you pick yourself up off the floor, I had asked my Dr. what the real cost would be if I had to pay out of pocket - this all happened as jobs were disappearing by the day here in the States - he speculated $45-$50,000 for any of DaVinci, open, or radiation only.

    This was in a Baylor system hospital in the Dallas area, prior workups done at Medical Center Plano (really good people at all of these providers).

    To compare with Randy's numbers, my hospital stand-alone bill was $34k. I never saw the actual paperwork, so can't say where the differences are or what was included. I did stay a couple of days more in the hosp. due to the extent of the surgery.
  • lion1
    lion1 Member Posts: 241
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    142 said:

    DaVinci cost as billed
    I went back and added up all of the original "billed" amounts from all of the doctors, hospitals, and labs involved. This has nothing to do with what insurance paid, nor any negotiating one might do before going in.
    This starts with the exam where they found the high PSA, includes the 12 sample biopsy, second opinion from the radiation oncologist, CT & Bone scans, two brief physicals to be sure I could undergo surgery, flu & pneumonia vaccinations to be sure I didn't get sick enough to have to reschedule surgery.
    Then DaVinci surgery, 4 days in the hospital, followups.
    I hope all the bills have arrived, but no promises.
    There is no consideration for any of the non-Rx stuff to get the house ready, travel, hotels, etc.
    I am 12 weeks out as of yesterday. My stats are very similar to yours, They are in my profile.
    $66,157.30 USD
    Now, as you pick yourself up off the floor, I had asked my Dr. what the real cost would be if I had to pay out of pocket - this all happened as jobs were disappearing by the day here in the States - he speculated $45-$50,000 for any of DaVinci, open, or radiation only.

    This was in a Baylor system hospital in the Dallas area, prior workups done at Medical Center Plano (really good people at all of these providers).

    To compare with Randy's numbers, my hospital stand-alone bill was $34k. I never saw the actual paperwork, so can't say where the differences are or what was included. I did stay a couple of days more in the hosp. due to the extent of the surgery.

    Cost
    LRP
    $30K HOSPITAL
    $18K-SURGEON--I paid 16k out of my pocket.

    Lion1
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,343 Member
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    At UC Irvine in So.CA.,which is a cancer center
    there is a very experienced doctor, (I'm not home now and I don't remember his name) who does davinci surgery. He only accepts cash. Since I had my biopsy at uc irvine, I was referred to him. The cost last march was 500 for a consult, 5000 for a prostate with no complication, and 6500 for one where there was nodule involvement. The hospital costs were separate. I did not use him, but he has performed lots of surgeries. If you need to know his name, I have the information at home, you can contact me at this site, or irakaget@yahoo.com, simply mention prostate in the subject line, so I do not delete.

    Ira

    ps by the way I believe that a davinci is a robotic assisted laprioscopic

    pps: how many cores were positive and what was the involvement?
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,343 Member
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    At UC Irvine in So.CA.,which is a cancer center
    there is a very experienced doctor, (I'm not home now and I don't remember his name) who does davinci surgery. He only accepts cash. Since I had my biopsy at uc irvine, I was referred to him. The cost last march was 500 for a consult, 5000 for a prostate with no complication, and 6500 for one where there was nodule involvement. The hospital costs were separate. I did not use him, but he has performed lots of surgeries. If you need to know his name, I have the information at home, you can contact me at this site, or irakaget@yahoo.com, simply mention prostate in the subject line, so I do not delete.

    Ira

    ps by the way I believe that a davinci is a robotic assisted laprioscopic

    pps: how many cores were positive and what was the involvement?

    docs name
    Thomas e. ahlering...............714 456- 6068 appt.
  • KJN
    KJN Member Posts: 6
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    docs name
    Thomas e. ahlering...............714 456- 6068 appt.

    Thanks
    Thanks to all of you for looking up those figures, and the phone number. Wow! Those prices are as bad as I had feared. Doing it in the US may not be possible for me. I'll keep looking around, and check out Irvine. I've heard that it may be possible to negotiate with some hospitals for the insurance company price. I'll see what I can come up with. Do any of you know if the price your insurance company paid was lower than the price that you quoted to me?

    I had my biopsy done in Bangkok. They took 24 cores. The right lobe showed no cancer, and the left showed cancer in 9 out of 12, but I don't know the percentage in each. The slides just arrived at Johns Hopkins yesterday for a second opinion.

    The urologist surgeon in Bangkok who did my biopsy does robotic assisted surgeries. He's done 180. He is supposed to have the most in Thailand, and he says he's got more than the leader in Singapore. I'm hearing that over 250 is a better bet. When I read of surgeons doing 1800 in the US, it sounds much better to me.
  • 142
    142 Member Posts: 169
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    KJN said:

    Thanks
    Thanks to all of you for looking up those figures, and the phone number. Wow! Those prices are as bad as I had feared. Doing it in the US may not be possible for me. I'll keep looking around, and check out Irvine. I've heard that it may be possible to negotiate with some hospitals for the insurance company price. I'll see what I can come up with. Do any of you know if the price your insurance company paid was lower than the price that you quoted to me?

    I had my biopsy done in Bangkok. They took 24 cores. The right lobe showed no cancer, and the left showed cancer in 9 out of 12, but I don't know the percentage in each. The slides just arrived at Johns Hopkins yesterday for a second opinion.

    The urologist surgeon in Bangkok who did my biopsy does robotic assisted surgeries. He's done 180. He is supposed to have the most in Thailand, and he says he's got more than the leader in Singapore. I'm hearing that over 250 is a better bet. When I read of surgeons doing 1800 in the US, it sounds much better to me.

    Billed vs. Insurance
    You are correct that there is a difference in cost. In my case there were things that the insurance would not pay, but were written off up front (mine only pays 6 biopsy cores, the Dr. won't do less than 12, and the lab has an agreement with the Dr. that helps cover the difference).
    There were a number of items considered "not covered" that were written off or reduced with some polite conversations (I have found some amazingly considerate people out there).
    The insurance companies in general also have fixed price or fixed percentage agreements for a long list of procedures with "in-network" providers and hospitals, which may not be the closest or the one you are familiar with.
    I can't say in detail what rules apply - I couldn't make sense of how some numbers were arrived at, but I would say the insurance company spent about $18,000, while I spent something over $5,000 (in respect to the hospital & doctors).
    If I had not been extraordinarily careful about selecting doctors and facilities that were within the insurance company's network, my part would have been at least $12,000, perhaps much more. This level of attention had to be kept up at every point I signed anything.

    And I pay a significant insurance premium, which can't be ignored in the total "cost".
  • macguy
    macguy Member Posts: 18
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    Cryosurgery
    You might want to check out cryosurgery. Although this method is not all that popular on this site it's suppose to be less expensive than surgery. www.upmccancercenters.com/cancer/prostate/cryosurgery.html
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,343 Member
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    KJN said:

    Thanks
    Thanks to all of you for looking up those figures, and the phone number. Wow! Those prices are as bad as I had feared. Doing it in the US may not be possible for me. I'll keep looking around, and check out Irvine. I've heard that it may be possible to negotiate with some hospitals for the insurance company price. I'll see what I can come up with. Do any of you know if the price your insurance company paid was lower than the price that you quoted to me?

    I had my biopsy done in Bangkok. They took 24 cores. The right lobe showed no cancer, and the left showed cancer in 9 out of 12, but I don't know the percentage in each. The slides just arrived at Johns Hopkins yesterday for a second opinion.

    The urologist surgeon in Bangkok who did my biopsy does robotic assisted surgeries. He's done 180. He is supposed to have the most in Thailand, and he says he's got more than the leader in Singapore. I'm hearing that over 250 is a better bet. When I read of surgeons doing 1800 in the US, it sounds much better to me.

    Doing it in the US may not be possible for me.
    Remember that you get only one prostate operation, so you want the best....

    I have medicare and a bluecross suppliment.........i notice that the various doctors that I saw ask more than what they accept thru these coverages..........so I think that you might be able to negotiate.....check out a few docs for price.

    As far as dr ahlering.........At a support group, I spoke with a physician who had the operation with him, and asked for a professional discount//////he did not receive it......

    What other countries are you considering for an operation, israel, austraila (sp), taiwan, etc

    Where are you from in the US, do you have a support group and a place to stay?

    ira
  • randy_in_indy
    randy_in_indy Member Posts: 496 Member
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    142 said:

    Billed vs. Insurance
    You are correct that there is a difference in cost. In my case there were things that the insurance would not pay, but were written off up front (mine only pays 6 biopsy cores, the Dr. won't do less than 12, and the lab has an agreement with the Dr. that helps cover the difference).
    There were a number of items considered "not covered" that were written off or reduced with some polite conversations (I have found some amazingly considerate people out there).
    The insurance companies in general also have fixed price or fixed percentage agreements for a long list of procedures with "in-network" providers and hospitals, which may not be the closest or the one you are familiar with.
    I can't say in detail what rules apply - I couldn't make sense of how some numbers were arrived at, but I would say the insurance company spent about $18,000, while I spent something over $5,000 (in respect to the hospital & doctors).
    If I had not been extraordinarily careful about selecting doctors and facilities that were within the insurance company's network, my part would have been at least $12,000, perhaps much more. This level of attention had to be kept up at every point I signed anything.

    And I pay a significant insurance premium, which can't be ignored in the total "cost".

    My Bill vs. what Insurance Paid
    I am very lucky with the company I work for has pretty good insurance. My annual maximum out of pocket is only $950. Since I met that with all the doctors seen since discovered in Oct 09 I wanted to get the operation done in 09 thus avoiding the additional $950 I'd be spending immediately after the Operation if I choose to wait and do in Jan or Feb. My entire operation cost will cost me $0 all covered 100% by insurance...however the doc's and hospital will not be getting at all what they billed. For example just got what the Insurance covered of the $26,015.00 hospital bill...insurance on paid them $10,997.15 making the provider eat the rest....right now I am loving my job and thank God for the insurance the company has - Anthem Blue Sheild Blue Cross. Can't wait to see the Dr's bills and see how the insurance denies them thousands...it's simply rediculous the cost charged on some line items. Now the surgeons...getting rid of my cancer...that is priceless and if forced to I would pay just about any amount...somehow.

    Randy in Indy
  • KJN
    KJN Member Posts: 6
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    Doing it in the US may not be possible for me.
    Remember that you get only one prostate operation, so you want the best....

    I have medicare and a bluecross suppliment.........i notice that the various doctors that I saw ask more than what they accept thru these coverages..........so I think that you might be able to negotiate.....check out a few docs for price.

    As far as dr ahlering.........At a support group, I spoke with a physician who had the operation with him, and asked for a professional discount//////he did not receive it......

    What other countries are you considering for an operation, israel, austraila (sp), taiwan, etc

    Where are you from in the US, do you have a support group and a place to stay?

    ira

    Other countries, US state
    Hopeful and Opt...

    I work in Japan and spend part of the year in Thailand with my wife who is from there. I have insurance in Thailand that will pay for an operation there, but I haven't found a surgeon with very high numbers there. That same insurance will reimburse me for surgery in any other country except the US. I'd still have to come up with the cash, but could get it back from them if I could get it pre-authorized.

    So, I could do it free in Thailand, but maybe with a less experienced surgeon. Doesn't sound too appealing. I could do it in the US, where it sounds like the best surgeons are, but I will have to pay for it all. Still, I want to do this right.

    Another option is doing it in some other country where I can find a high volume surgeon, pay for it up front, and hopefully get a refund. That would be great. But finding a surgeon that I can trust in an unfamiliar country is an overwhelming task. I'm looking into it, but just scratching the surface at this point. Japan isn't looking too promising.

    I grew up in northern California, but don't have family there any more. I have siblings in the Seattle area and the outskirts of New york City, so I have places to stay, there. I am looking around the New York area, because there are many famous hospitals there and in neighboring states. My sibling there is a cancer survivor (8 years). That is my support group in the states at the moment.
  • 2ndBase
    2ndBase Member Posts: 220
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    Anolther Option
    Surgery is not the only option you have. Radiation can kill all the cancer in the prostate. I was 52 with psa of 24 and Gleason of 9 and only had radiation and I have no cancer in my prostate today. There are less side effects this way also. Hope this helps.
  • KJN
    KJN Member Posts: 6
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    2ndBase said:

    Anolther Option
    Surgery is not the only option you have. Radiation can kill all the cancer in the prostate. I was 52 with psa of 24 and Gleason of 9 and only had radiation and I have no cancer in my prostate today. There are less side effects this way also. Hope this helps.

    What type of radiaton treatment did you have?
    2ndBase

    What type of radiation treatment did you have? I have heard that some can cost more than surgery.
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,343 Member
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    KJN said:

    Other countries, US state
    Hopeful and Opt...

    I work in Japan and spend part of the year in Thailand with my wife who is from there. I have insurance in Thailand that will pay for an operation there, but I haven't found a surgeon with very high numbers there. That same insurance will reimburse me for surgery in any other country except the US. I'd still have to come up with the cash, but could get it back from them if I could get it pre-authorized.

    So, I could do it free in Thailand, but maybe with a less experienced surgeon. Doesn't sound too appealing. I could do it in the US, where it sounds like the best surgeons are, but I will have to pay for it all. Still, I want to do this right.

    Another option is doing it in some other country where I can find a high volume surgeon, pay for it up front, and hopefully get a refund. That would be great. But finding a surgeon that I can trust in an unfamiliar country is an overwhelming task. I'm looking into it, but just scratching the surface at this point. Japan isn't looking too promising.

    I grew up in northern California, but don't have family there any more. I have siblings in the Seattle area and the outskirts of New york City, so I have places to stay, there. I am looking around the New York area, because there are many famous hospitals there and in neighboring states. My sibling there is a cancer survivor (8 years). That is my support group in the states at the moment.

    Hi I don't know much about doctors in the seattle area,
    however in nyc there are top doctors, there are two robotic surgeonsthat are supper stars in NYC........I not home now, so I will have to get back to you

    Ira
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,343 Member
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    Hi I don't know much about doctors in the seattle area,
    however in nyc there are top doctors, there are two robotic surgeonsthat are supper stars in NYC........I not home now, so I will have to get back to you

    Ira

    david b samadi, md
    ashutosh k. tewari, md
  • macguy
    macguy Member Posts: 18
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    IMRT costs
    21 Century Oncology in Clarkston, MI told me my share of the $80,000 to $100,000 costs for Intense modulated radiation therapy would be $8,000 and Medicare would pickup the rest. I believe medicare will reduce their invoice somewhat. I am waiting for the Henry Ford Hospital costs to come in.
  • KJN
    KJN Member Posts: 6
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    macguy said:

    IMRT costs
    21 Century Oncology in Clarkston, MI told me my share of the $80,000 to $100,000 costs for Intense modulated radiation therapy would be $8,000 and Medicare would pickup the rest. I believe medicare will reduce their invoice somewhat. I am waiting for the Henry Ford Hospital costs to come in.

    IMRT Costs
    Yeah, that's what I was afraid of. I have to pay for anything in the US out of pocket. Johns Hopkins has quoted me surgery at around $21,000. Surgery in Sydney, Australia is around the same price. If I can come up with that amount, that's probably the route I will go. Right now, I am still trying to see if I can pull that amount together. It's a struggle at this point. This was all a big surprise, of course, as I'm sure it was for everyone here.
  • macguy
    macguy Member Posts: 18
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    IMRT costs
    Henry Ford Hospital in Detroit gave me an approximate quote that my share of the costs with medicare would be $4,600 for 43 treatments and now I have an appointment at Beaumont Hospital in Troy, MI for another quote. Apparently it pays to shop around.
  • macguy
    macguy Member Posts: 18
    Options
    IMRT costs
    Henry Ford Hospital in Detroit gave me an approximate quote that my share of the costs with medicare would be $4,600 for 43 treatments and now I have an appointment at Beaumont Hospital in Troy, MI for another quote. Apparently it pays to shop around.
  • jminnj
    jminnj Member Posts: 129 Member
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    Robotic Cost
    Just had my robotic 2 weeks ago. The surgeons bill was about 25K, and then 43K for the hospital. Of course, with HMO they are not getting anywhere near those amounts and I am responsible for about $1,200 of the total costs.I live in Northern New Jersey.