An Elbow Injury Exposes the Exorbitant Costs of Health Care

 An Elbow Injury Exposes the Exorbitant Costs of Health Care

A patient banged my right elbow playing hockey, and went to the hospital. Doctors diagnosed it as bursitis. In late May, he became feverish and delirious. He checked into Hoboken University Medical Center. An emergency-room physician diagnosed sepsis based on blood and other tests.

His hospital’s $185,037.45 bill includes $13,500 for an MRI of his elbow, $9,500 for a CAT scan and $17,797.12 for two x-rays. “Laboratory” expenses related to blood tests carried out throughout the stay, totaling at $44,787.96. The bill for the semi-private hospital room is $54,000, or $18,000 per night. The hospital’s charges were concerning and struck him and two physicians he ran them by as high. A medical-imaging Web site says “upper-extremity” MRI scans cost between $1,050 and $7,000; another site says overnight hospital stays average $11,700.

His personal payments have been minimal because he is insured by Cigna Health. He notified Cigna of the situation shortly after being admitted to the hospital, and Cigna authorized the hospital stay and surgery as “emergency treatment.” That means Cigna defines my out-of-network care as in-network because of the lack of options. Just because Cigna authorizes the treatment does not mean it must pay what caregivers charge. Caregivers can pressure the insurance company to increase reimbursements they consider too low.

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