Cost of a PSMA in US part 2

[TJGuy]

My earlier post I wrote about the cost of. PSMA pet scan.

I had tried for ever (years) to find out what these cost to no avail, and of course any company/ hospital in the US can charge what ever they wish.

I just received the bill from the hospital which performed it.

Brace yourself self for the cost, $36,915.71. US dollars.

Hospital bill shows my deductible and BCBS picking up the rest.

When I get the EOB from BCBS I'll post again what it shows as the actual cost to BCBS after their negotiated "discount" from the hospital.

I had written earlier in Canada I could have received a PSMA pet scan at a private health care provider for $2415 as a US citizen.

Since I'm on the east coast, I would have had to fly to Vancouver BC, and that airfare was at the time I was looking incredibly cheap. Around $200 round trip, possibly less. Connecting through Toronto.

Now if I drove to Toronto and purchased a round trip ticket to Vancouver it was less than $100 I believe. Those ticket prices probably aren't available all the time but they were in June 2023.

Now remember in India and Australia I've seen prices in US dollars much less than $1000. Around $600 in past few years.

[Hidden]

Of course the hospital will bill BCBS as much as they can, and then see what they can get.

Kaiser Permanente billed $4138.00 to Kaiser Health Plan foundation for my PSMA PET.

The plan rate check to Kaiser Permanente was $3110.00 The Pylarify was included.

Another instance, I was sent to an outside facility they billed $18350.00, and were approved for $6161.00

So prices are all BS!!!!

As a cash paying customer you can walk into any facility that does PSMA PET scans, and negotiate a good cash rate.

Let's keep this going. It would be great to see others' EOBs

[maley2711 in reply to Hidden]

As I recall, the total here at Kaiser Northwest was approx $9000, which included Pylarify. Sme difference compared to your Kaiser region? They miscoded the Pylarify and tried to stick me with a $600 copay....appealed and won.

[OldVTGuy]

My hospital on New England had an insurance rate of around $8500 I believe and a rate of like $5000 for a patient with no insurance. I suppose BCBS would probably negotiate the $8500 down even a bit more. Both rates are listed on their website. Very transparent.

[PJ95]

Dana Farber BCBS EOB Oct 2022 Radiologist fees were not included charged in seperate filing

Document

[babychi]

$700 approx in 2017 in NSW Australia, unsubsidised by Medicare.

[MyDad76]

This is just insane. And immoral. in Austria it is around 4.000 US dollars. And Austria is not some poor third world country with low GDP where the cost is expected to be lower.

[Atdabeach]

Johns Hopkins billed Medicare $17,931 for mine (the test itself, I'm sure there were some additional charges for interpretation, etc.) last July, and Medicare approved $1,874.

[maley2711 in reply to Atdabeach]

what a game ...theoretically Hopkins will go broke if that continues?????

[TJGuy in reply to maley2711]

What I understand goes on is this.

So hospitals get tax free status by providing community service (lower or free service) to patients without health insurance or unable to pay. Most hospitals don't come anywhere near this obligation and don't even try, but pay no taxes just the same.

So they inflate the costs, then show a loss on paper for providing the service. This is all smoke and mirrors but it works for the hospital to show they took a loss. So now they don't actually need to actually help those without health insurance or are poor.

They will sue all those poor patients, dieing or not, dragging them into court, which will cost them plenty for legal representation, garnish wages, put liens on any property they own. Pretty much ruin their credit, destroy their lives, and leave them broke.

[maley2711 in reply to TJGuy]

don't believe it is all exactly as you say......any sources for your explanation?

[TJGuy in reply to maley2711]

There have been investigative reports on my local news station in a major city that did many indepth reports in a healthcare series. About the obligation of hospitals in regards to community service. As well as extensive reporting of the poor in our city who are brought to court, as I've described.

And the pricing of procedures, especially surrounding Medicare pricing and hospital billing resulting in paper losses.

The excessive list pricing is used as a way to document losses. These excessive prices have a real effect for those without insurance.

The state insurance commissioner has warned and publicly stated many times that big hospitals have lost their mission of providing care. That they have instead become investment banks and property development companies.

[maley2711 in reply to TJGuy]

providence and Kaiser included???? The state medical scholl hospital here?

A loss is revenues less than expenses......not a "paper" loss. That would be like telling my employer that I'm worth $70/hr, but since I'm paid just $40/hr., I'm losing money????????

Now, depreciation on equipment can result in a paper loss, when cash flow is actulaly positive. BTW, I do read about hospitals becoming insolvent and closing down.

I don't necessarily just buy what I see on the evening news. My wife worked at Kaiser for 27 years.

I'd need to check other sources re the non-profit desgnation just for helping x number of poorer patients. Here are several.......

irs.gov/charities-non-profi...

americanprogress.org/articl....

So, just helping poorer patients is not enuf to qualify for non-profit service...so either you misunderstood, or the reporter didn't know what he/she was talking about?

[Qrak]

I Poland between USD 1500 - 2000.

[MyDad76 in reply to Qrak]

Did you had the test done in Poland? Can you please tell me where? If I will not be able to arrange the test for my dad within one month in Slovenia, we will go abroad.

[Qrak in reply to MyDad76]

Kielce

onkol.kielce.pl/pl/centrum/...

Warsaw

hifu.pl/diagnostyka-raka-pr....

onkolmed.pl/wpis/189,pet-ps...

Białystok

bioskaner.eu/2020/11/30/abm...

umb.edu.pl/owbk/prospetmr2021

[MyDad76 in reply to Qrak]

Thank you

[Qrak]

I had mine done in Canada, but did some research in Poland some time ago.

I will ask my Polish contacts for current recommendations.

[Doseydoe]

Had one 6 weeks ago, $1300 AUD

[Gmailer]

I did several of them starting in March, 2017 for about $550.00 total in India. Once when they didn't have it I did have to go to another hospital that charged me $350.00. Crazy is all it is. I have had five of them I think in India over the years, and of course that was when they weren't available here. Not sure when they were available here. And Lu177 was around $20,000.00 with all hospital costs included. That was for at least three treatments. Probably less now since the rupee has fallen around 30% since then. I did check it out, and was a good candidate for it, but the vaccines were still working then. I have been on APCEDEN since March, 2017. I'm not great, but I am still here after all of this. PSA was 212 with plenty of bone Mets back then. Surprisingly I haven't had them since back then. Crazy they were gone. Lucky I found them.