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The True Cost of a C-Section

January 22, 2015
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Medical costs in the U.S is a hot button topic and as a rule, I avoid hot button topics. It’s like Ferris Bueller and his isms. He doesn’t condone isms of any kind and really, I have to agree. I decided to write this post anyway. It’s all over the media and internet that medical costs in the U.S. are ridiculously high. It’s also all over the media and internet that the rate of c. sections in the U.S. is ridiculously high, and I always hear that a c-section runs about $30,000. Being the curious person that I am, I’ve wondered…how much does it REALLY cost?

When I was pregnant with and gave birth to my daughter, we had an HMO, so I never actually saw a bill for any of those medical costs. Our only out of pocket expenses were my diabetes testing supplies, which I estimated at maybe $100. With Grayson, we have a PPO. I knew from the start that this change would mean that we’d have significantly more out of pocket costs, but I was happy to see how much it *really* costs for prenatal care, delivery, etc. Yeah, maybe I was looking for a silver lining. Whatever. I was still excited to set up a spreadsheet to keep track of these costs. I love me some spreadsheets.

So that is exactly what I did. I set up a spreadsheet and diligently kept track of what was billed to the insurance, what the contracted cost was, what the insurance paid and what we paid. Now, while I think of pregnancies as run of the mill, it should be noted that I did have the sequential screening and Gestational Diabetes. Both of these added some cost, but I also talked my way out of that horrid 3-hour Glucose test, so there obviously wasn’t a charge for that. I’m still so glad I talked my way out of that one. It still stands out in my mind as one of the worst parts of my pregnancy with Annabelle. While perusing this cost breakdown, keep in mind that I really cannot complain about the medical care I received with either pregnancy. Also, it goes without saying that the kids are priceless and we’re all here safe and sound.

Oops, I’ve already bored Jake to sleep.

Before we proceed with the cost run down, you need to know the following. Each cost will be broken down by was was billed to the insurance, the contracted/pre-negotiated cost, what the insurance paid and our out of pocket costs. You will also notice that the costs aren’t in U.S. Dollars, Canadian dollars, pesos, Euros or yen. Instead, they are in CBB, or Chipotle Burrito Bowls.  Yep, Chipotle Burrito Bowls, because it occurred to me that sometimes you have to put things in perspective. Plus, in addition to spreadsheets, I also love me some Chipotle and yes, we go often enough that I know exactly how much our order is going to be. I contemplated doing this in skeins of yarn, but those can vary pretty widely depending on fiber content, dyeing technique, etc, whereas our Chipotle order is a much more stable cost comparison. And while some of you may not fully appreciate a skein of really nice yarn, I’m confident that you all recognize the value of a Chipotle meal. Without further ado, here we go!

Grand Total:
Billed Cost – 4557 CBB (Dude!! That’s YEARS of Chipotle!)
Contracted Cost – 2078 CBB
Insurance Paid – 1836 CBB
Out of Pocket – 242 CBB

This cutie pie is definitely his weight in gold, I mean CBB.

Interesting Highlights (or maybe not so interesting) –

The Nurse Anesthetist (B – 101, C – 61, Ins – 55, OOP – 6) was awesome. He spent the whole surgery, putting cool cloths on my forehead. I think he also held the barf basin when I got sick. What a guy. He was worth 6 CBB. Coincidentally, the Anesthesiologist himself was the same price. He arrived after I was in the OR, talked to me for half a second, gave me the drugs and then disappeared. Maybe he was in the room, maybe not. I don’t know and I didn’t care because I was so so so happy for the drugs, so yeah, he was worth 6 CBB as well. Then again…that 6 CBB doesn’t count the drugs themselves (B – 79, C – 33, Ins – 30, OOP – 3). How about this, Total for the anesthesia drugs, Nurse Anesthetist, Anesthesiologist was 15. For all of that, 15 CBB is fine with me.

Next, let’s discuss the Recovery Room (B – 252, C – 106, Ins – 96, OOP – 11). I was in the Recovery Room for 2 hours after Surgery. The billed rate for this room is 2 CBB per MINUTE. However, they have a pre-negotiated agreement that says we only pay 1 CBB per Minute. Damn! Those are some expensive minutes! Granted, they’re also fairly critical minutes having just been cut open, baby removed and sewn back together. And there was a nurse sitting basically right by my head the entire time, so she deserves some CBB. She also provided us with one of the more humorous parts of the day, which makes her worth extra CBB in my mind.

You see, I had been overheating prior to surgery and Jake and this nurse had been laying washcloths soaked in ice water on my head, back, etc. It would take about a minute for my body to take an ice cold cloth and make it steaming hot. This was a LITTLE bit better during surgery, probably because they keep the OR as cold as meat locker. OMG, it felt like heaven. Anyway, a common side effect of the spinal is shaking and wow. I had the shakes so bad! They don’t hurt or anything, just annoying. So we got to the Recovery room and the blood pressure cuff couldn’t get a reading because of the shaking and the pulse oximeter couldn’t get pulse for the same reason. Then she when tried to take my temp, it came back at 90 degrees with two different thermometers and she said “Hmmm.” And when we looked at her quizzically she said “Well, you’re not among the living.” I’m not?! For the record, the afterlife looks exactly like a recovery room.  I assume she’d have been slightly more alarmed if I hadn’t been conscious and talking to her at that moment. Still, all that ice water had apparently had the desired effect of cooling me down, but maybe it went a bit too far. So they covered me in warm blankets.

Alright, back to costs. Now, I also got charged for a Labor & Delivery room (B – 958, C – 405, Ins – 364, OOP – 40). The really funny part of this is that the L&D room and the recovery room were the exact same room! In my head, I’m picturing that thing they do on TV where the wall spins and when you get back to where you started, it’s a completed different room. Except in this case, it wasn’t.  Alright, maybe that only makes sense in my head. Moving on now.

I was in the L&D room for an hour, tops. So while the Recovery room was charged at 2 CBB per minute, the L&D room was 16 CBB per minute. Yes, those are also critical minutes, right before surgery but all they really did was take blood for labs, and expect me to answer lots of annoying questions. I’m sure that their donor breast milk program is wonderful but when I’m having contractions? I DO NOT CARE. Just tell me where to sign.

Now, it’s possible this L&D room charge also includes our time spent in L&D triage because I don’t have an charge for that. In that case, the cost per minute comes down to 4 CBB per minute. Yeah, they had to check on me, start an IV and call the Dr a couple times, but that still seems high. Especially when you compare it to my Post-partum room (B – 187, C – 79, Ins – 71, OOP – 8). The billed rate for that room was 4.5 CBB per hour, which is 0.1 CBB per minute. WOW. That’s a steal! They still had to check on us, bring me drugs, test Grayson’s blood sugar and do vitals for both of us, so you would think it’d be fairly similar in terms of cost. Plus, this nurse was also funny which, as already mentioned, makes her worth more.

Moving back in time to prenatal costs, I had 4 ultrasounds over the course of this pregnancy, not counting the super quick one we had at 8 weeks to check for a heartbeat. The average cost per ultrasound (B-84, C – 36, Ins – 21, OOP – 14) is kind of misleading. The really interesting part is that they range in billed cost from 116 to 35. I understand that each ultrasound had a different purpose but really…it seemed to be the same. Measure a bunch of stuff to determine that things are going the way they’re supposed to. Why such a big gap in costs? They were all done at the same facility.

The one cost I really have heartburn over is the Glucose test (B – 11, C – 4, Ins 3, OOP – 1). Yeah, it’s important yada yada yada and actually all of the lab work was surprisingly cheap! But still. They basically give you a sugar bomb, then take your blood one hour later. Keep in mind, I knew going in that I would fail (I did) because I had been monitoring my sugars already and knew they’d be high, but I know there’s a procedure they have to follow. I get it. So I drank my sugar bomb and let them take my blood an hour later. No biggie right? Except that as I sat there I got that feeling. That “OMG, I’m going to pass out” feeling. I told the vampire phlebotomist that I needed to sit a minute. Then I asked for water and she also gave me some crackers. I plopped my head down on my arm rest and concentrated on my breathing while she put cool paper towels on my neck. I asked her to pour the ice water on my head but she laughed. I guess she thought I was joking. I wasn’t. A couple minutes later I was fine and I came back to the waiting room with my water and crackers. Jake knew right away that it hadn’t gone well because it took longer than everyone else and I was the only one who came back with refreshments. What can I say? I like to make sure I get my CBBs worth. Although it still seems like a poor trade. I gave them a CBB and in return they made me nauseous, poked me with a needle and gave me some water and crackers. What a deal! Everyone should do it.

Still it could be worse. I have nightmares about that stupid 3 hour test. It’s torture. The CIA should consider this tactic when interrogating people. They’d start talking for sure.

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