Modern medicine has allowed physicians to perform treatments for diseases that may have otherwise condemned afflicted patients to certain death in the past. Invasive operations ranging from dental extraction to heart transplant would have been unthinkable if not for a critically effective pain killer. One can only imagine medieval surgeries that employ the use archaic preoperative sedatives that are limited to alcohol and opium.
The gift of modern anesthesia does not always work without its own dangerous side-effects. In fact, the most recent research conducted by an associate professor of anesthesiology at Dartmouth-Hitchcock Medical Center in New Hampshire estimated that 3 out of 10,000 patients undergoing surgical procedures die due to the adverse effects of current anesthetic applications.
However, it is important to understand that the related mortality is attributed to certain factors that increase the risks of death or dementia. These includes (but are not limited to) drug-related allergies, smoking, obesity, old age and scheduling operations at a later timeslot (from 4:00 PM to 6:00 AM). These factors can be resolved with careful adjustments before and after the operation. In essence, anesthesia remains a standard component that makes all surgical procedures possible.
Crude Average Estimate
There are two basic categories for defining the broad average cost of anesthesia during operations – out-of-pocket price and medical coverage. Patients who are insured by the medical insurance plans may only pay a fraction of the total cost (coinsurance) that ranging from 20% to %50. However, these marginal costs may vary depending on the scope of the health plan’s policy.
The government-issued Medicare plan can cover a certain percentage of the overall anesthesia cost depending on their enrollment type. Original Medicare naturally has more coverage for inpatient operations (e.g. emergency room referrals) than those categorized under outpatient (e.g. minimally invasive surgery).
For patients who do not have medical insurance, the crude estimate is anywhere between $500 to more than $3,500. The broad range of variance in terms of actual cost is largely tied up to the kind of operation being performed and other numerous factors that contribute to the procedure’s complexity. Case in point: the general anesthesia price inclusive of the heart surgery may cost up to $2,500 while a local anesthesia required to fix a broken leg may only cost $469.
Official Costing Formula
Judging from the narrative of the previous part of the article, knowing the insured and out-of-pocket costs is a lot more complicated than it seems. Hence, the common (and sometimes outraged) inquiry of the American public is “how much does anesthesia cost, really?!” Similar to the problem, the clearer answer is not so simple either.
According to Diversified Professionals, the exact cost of anesthesia is determined by this standard mathematical formula: (Base Unit + Modifiers + Time) x Conversion Factor. These are the following definitions for each part of the equation:
Base Unit
This part of the equation includes the standard pre-operative and post-operative requirements that determine the type of anesthetic procedure. This factor already includes the required volume of anesthesia units (usually $60 to $64 per unit).
Modifiers
From the root word ‘modify,’ this part of the equation pertains to certain circumstances that affect the parameters of the anesthesia application. Factors such as the real-time physical status of the patient contribute to the complexity of the entire operation. As a crucial part of the equation, modifiers ensure that the application of anesthesia and the entire operation would not trigger any adverse effects that worsen the patient’s well-being.
Time
A single unit of anesthesia is effective within the standard 15-minute window. In essence, the more protracted the operation is, the more units are required to block the pain. The time coverage ends when the patient is already transferred to the post-operative care.
Conversion Factor
This equation pertains to the total amount of money the customer/patient needs to pay per anesthesia unit. It is important to understand that apart from the annual publication of Medicare’s fixed cost, private insurance companies do not disclose the details of their agreement with individual anesthesia groups.
Anesthesia Discount
There are certain ways for individuals to avail of advantages in terms of the out-of-pocket general anesthesia price. Hospitals often offer their own discount for patients who are paying in cash. However, it is important to take note that one may have to satisfy certain eligibility tests in order to avail for higher discounts policies offered in various medical centers.
Another way for individuals to get a better deal out of budgeting for the anesthesia cost is through collecting coupons. As of 2017, online directories like Anesthesia Prep and Prodigy feature discount coupons that slash out 10% to 30% of the overall cost for anesthesia.
The American Society of Regional and Local Anesthesia and Pain Medicine have also introduced their featured Group Membership Discount. Granted that prospective members follow the specific guidelines and provisions of the membership, eligible candidates can avail a $25 worth discount for their anesthesia procedure.
Sutter Health Data
When it comes to transparency, it is curious to take note how a renowned heath system in Northern Carolina disclosed the actual cost of anesthesia under each of its umbrella hospitals and medical centers. So, how much does anesthesia cost under Sutter Health? These are the list of prices underscored by their Medicare reports as of 2012:
- $45: Sutter Coast Hospital (Crescent City)
- $50: Sutter Davis Hospital (Davis)
- $66: Sutter Auburn Faith Hospital (Auburn)
- $68: Sutter Tracy Community Hospital (Tracy)
- $70: Sutter Solano Medical Center (Vallejo)
- $78: Memorial Medical Center (Modesto)
- $101: Sutter Lakeside Hospital and Center for Health (Lakeport)
- $102: Sutter Roseville Hospital (Roseville)
- $111: Menlo Park Surgical Hospital (Menlo Park)
- $114: Alta Bates Summit Medical Center (Berkeley)
- $135: Memorial Hospital (Los Banos)
- $148: Sutter Maternity & Surgery Center (Santa Cruz)
- $165: Sutter Amador Hospital (Jackson)
- $186: Sutter Medical Center (Santa Rosa)
- $187: Mills-Peninsula Health Services (Burlingame)
- $207: Sutter Medical Center (Sacramento)
- $207: Eden Medical Center (Castro Valley)
- $213: Sutter Delta Medical Center (Antioch)
- $218: California Pacific Medical Center (San Francisco)
- $260: Novato Community Hospital (Novato)
- $286: Marin General Hospital (Greenbrae)