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The Lowdown on Medical Charges in the US

coverage for high cost of surgery hospitalization in US with visitor insurance

Hospital pricing rates in the US are notoriously difficult to predict, calculate, and find out. If you are unlucky enough to be involved in an accident or suffer from illness in America, you need to know what your care costs and how you are going to pay for it. How much do you expect to pay if you visit the ER with a broken leg? How much would it then cost for occupational therapy? What about pulmonary therapy, or the charges for the operating room? Take a look at what’s included – and what’s not – in some of the most commonly utilized healthcare services in the US. If you are visiting the US, are you covered by visitors health insurance, how much will your travel insurance cover you for if you have preexisting conditions and have to be treated in the US?

Emergency Room Charges in the US

The Emergency Room(ER) is the place you don’t want to end up – especially if you do not have health insurance. The ER, as the name explains, is for emergency cases and those conditions that require immediate and specialized help. Therefore, the charges are steep. Unfortunately, most people are unaware of how the charges are calculated and exactly how much they are spending, so they are surprised when the bill arrives.

Generally speaking, the charges are set according to the level of care provided. This includes the type of accommodation you need, the personnel needed on the case, the amount of time treatment is given, and the intensity and complexity of the treatment. Most often the charges do not include the cost of drugs, appliances, and additional ancillary procedures, or for the time of the physicians.

According to a 2013 study from the University of California San Francisco, there exists a vast range of different pricing scales in emergency rooms across the US. Researchers from the university revealed that patient charges went from $4 to $24,110 for simple strained muscles and sprains, from $15 to $17,797 for treatment for a headache, $128 to $39,408 for kidney stones, $50 to $73,002 for urinary tract infections and from $29 to $29,551 for gut infections.

The Washington Post revealed that the average emergency room visit costs more than an American’s average month’s rent – the average charge was set at $1,233, 40 percent greater than the average US rent of $871 per month.

Beware of going to the Emergency Room if you do not have a life-threatening emergency because you could end up with a huge bill for nothing (and you will likely wait for hours before you are seen). It is better to go to an ER-alternative such as an urgent care center, a retail health clinic, or a walk-in doctor’s office.

Prices for the OR (Operating Room)

Again, the amount you need to pay for Operating Room (OR) procedures depends on the complexity of your medical case. Of course, the more complex the procedure, the more you will pay. According to OR pricing data from Akron General hospital, the most basic level of treatment has an initial fee of $617 and is then charged at $26 per minute, while the most advanced level of treatment has an initial fee of $5,420 and is charged at $57 per minute. Cardiac Surgery charges are different, and there are additional charges for anesthesia. Plus, physician fees are not included and are billed separately by the medic.

Cleveland Clinic prices their OR by setting the Level 1 initial 30 minutes at $1,769, with each additional 30 minutes at $1,769, and for Level 6 the initial 30 minutes is $3,336 and each additional 30 minutes is priced at $3,336.

Fees for Pulmonary Therapy

When it comes to pulmonary and respiratory therapy there are a wide variety of procedures available and a different rate card depending on the treatment given to the patient. These techniques vary from Aerosol Therapy ($139 at Akron General) and Arterial Puncture ($122) to Non-Invasive Ventilation (Initial) at $1,015 and Volume Ventilator (Initial) costing $1,015. The Cleveland Clinic charges for Inhalation Treatment at $161 and also sets the charge for demonstrating and evaluating the nebulizer at $209.

How Much is Occupational Therapy?

Charges for Occupational Therapy cover treatment and rehabilitation for a variety of pain conditions and injuries and the techniques used will differ according to which hospital you are treated at.

According to the Cleveland Clinic, an Occupational Therapy Evaluation & Report costs $428, while Therapeutic Exercise is $164 per 15 minutes. Attendance at a Therapeutic Group costs $105. At the Mayo Clinic, an Occupational Therapy Evaluation is $240, and a reevaluation is $160.

High Charges Equals Essential Health Insurance

A quick look at these charges and those listed in the infographics reveal how large your bill could become if you suffer from an accident or illness in the US. Because the pricing scales and policies are different in every hospital it is important to seek the rate card for the specific procedure you are having, and also to talk to the hospital about any additional charges. If you’re looking for all the statistics on US medical charges, Forbes recently put together a comprehensive article with links.

Remember, to be able to afford the cost of even a simple mishap like a broken finger, or a more serious occurrence like a heart attack, you need to be covered by health insurance.


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