It is important to recognize that an investment in Discseel should not be compared to zero-cost spine surgical alternatives. The cost of spine fusion without health insurance can range from $80,000 to $150,000 or more. Geographically, the cost of spinal fusion can vary. For example, the cost in urban or major cities tends to be higher than in rural areas or smaller towns. The cost for the same procedure with health insurance will depend on several variables.
The Cost of Spine Surgery: Variables to Consider
1. Insurance Plan Coverage: The extent of insurance coverage plays a crucial role in determining the out-of-pocket expenses for spinal fusion surgery. Different insurance plans may cover a percentage of the cost or require the patient to meet a deductible and co-insurance. It is essential to review the insurance policy documents or contact the insurance provider directly to understand the specific coverage details for spinal fusion surgery.
2. Prior Authorization: Insurance companies may require pre-authorization for spinal fusion surgery. This involves submitting relevant medical documentation to demonstrate the medical necessity of the procedure. Failure to obtain pre-authorization may result in denial of coverage or higher out-of-pocket costs.
3. In-network vs. Out-of-network Providers: Insurance plans often have a network of healthcare providers and facilities with negotiated rates. Choosing an in-network surgeon and hospital or surgical facility can result in lower out-of-pocket costs. Out-of-network providers may result in higher expenses or denial of coverage, depending on the insurance plan.
4. Deductibles, co-insurance and Co-pays: Insurance plans typically require patients to meet a deductible, which is the amount they must pay out-of-pocket before the insurance coverage kicks in. Understanding the deductible, co-insurance and co-pay requirements of the insurance plan is crucial in estimating the overall cost.
5. Coverage Limits: Insurance plans often have coverage limits or maximums, both for a single procedure and for the entire policy period. These limits can impact the out-of-pocket expenses for spinal fusion surgery. Once the coverage limit is reached, the insurance company may cover the remaining eligible expenses. Patients should review their insurance policy to understand these limits and plan accordingly.
6. Procedure Complexity: The complexity of the spinal fusion surgery, which may involve multiple levels of the spine or the need for additional hardware, can significantly impact the cost. More complex procedures tend to be more expensive. Spinal fusion can be performed through different techniques, including anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), or posterior cervical fusion. The choice of technique depends on factors such as the location and severity of the spinal condition. Different surgical approaches, such as ALIF, PLIF, or TLIF, may have varying costs due to differences in equipment, surgical time, and expertise required. In some cases, spinal fusion involves the use of implants and instrumentation such as screws, rods, or cages. The cost of implants and instrumentation can significantly contribute to the overall expenses of the procedure.
7. Surgeon’s Fee: The fee charged by the surgeon for the procedure can vary depending on their experience, expertise, and reputation.
8. Hospital or Surgical Facility Fees: The choice of hospital or surgical facility can affect the cost. Different facilities may have varying pricing structures, and certain facilities may be more expensive than others. It is essential to consider this when estimating surgery costs.
9. Anesthesia Costs: The cost of anesthesia will depend on factors such as the duration of the surgery and the type of anesthesia administered. There are occasions when the procedure and surgeon are in-network, but the anesthesia fee ends up being out of network.
10. Reality Check Cost: Even though spine surgery has a role in certain specific circumstances, it should never be considered a “cure”. A spine operation will surgically alter your spine anatomy but can never return your spine to normal. A discectomy can remove herniated disc material compressing on a nerve but cannot surgically sew the disc fissure that allowed the herniation in the first place. That is why recurrent disc herniations can occur in the same disc even after a successful discectomy. A laminectomy procedure removes bone from the vertebra rendering the spine less stable. This instability can eventually cause one vertebra to slide forward or backward (spondylolisthesis) over its adjacent vertebra. Spine fusion uses rods and screws to connect two or more spine vertebra together to eliminate their motion relative to one another. The unintended consequence of doing so is that the adjacent mobile discs start to breakdown faster (adjacent segment degeneration) transferring the original problem to other spine levels over time.
11. Cost vs Value: Patient cost is a measure of the dollars paid for a given service. Value represents what a patient gets for that cost. Spine surgery, even under ideal circumstances, leaves the spine in a state where future problems are virtually guaranteed to occur. This is not a criticism of spine surgery technology or the surgeons who perform the procedures. Rather it is an anatomical and biomechanical acknowledgement of the limitations of the application of surgical technology to the human spine. In the final analysis, Discseel is a reasonable alternative from a cost standpoint, but a superior value when compared to anatomy altering spine surgical procedures.
12. The Discseel Non-Surgical Alternative: DISCSEEL is a new non-surgical procedure that treats chronic pain from low back disc fissure conditions like bulges, protrusions, herniations, extrusions and degenerative disc disease. Disc fissures will not heal by themselves and cannot be surgically sewn because discs lack an adequate blood supply. DISCSEEL can help you avoid the prospect of spine surgical procedures like discectomy, laminectomy, disc replacement and of course spine fusion. The DISCSEEL procedure uses x-ray guidance to inject the healing protein fibrin, which immediately seals disc fissures and initiates a healing process. You make the same fibrin for spontaneous healing of other injuries; you just don’t have sufficient blood supply in your discs to deliver fibrin – that’s where DISCSEEL comes in. Other spine injection procedures using stem cells or PRP cannot successfully seal disc fissures like fibrin can.
DISCSEEL has limited availability around the country because it requires a specific license to perform. Boris Terebuh, MD is Ohio’s first & most experienced licensed DISCSEEL provider with over 100 cases performed and conveniently located in Dublin, Ohio. Already, people have traveled from as far away as Europe, Hawaii, Utah, Colorado, South Dakota and twelve other US States.
Because the procedure is performed in our office, there are no additional facility fees or anesthesiology fees. The combination of these factors could ultimately save you thousands compared to other DISCSEEL providers. If you are considering lumbar DISCSEEL for yourself, please call our office today (614) 999-9899 to find out if your low back condition could benefit from this revolutionary new procedure. You can also learn more about DISCSEEL on our website: RegenerativeSpineAndJoint.com
If you personally do not require low back DISCSEEL, please share this information with family members or friends.
Sources:
livewell.com “How Much Is Spinal Fusion Surgery With Insurance?” Published: November 8, 2023
livewell.com “How Much Is Spinal Fusion Surgery Without Insurance?” Published: November 16, 2023