(Boston) - What is the cost of cervical disc surgery?

April 13, 2014 8:24 AM

After 2 years of dealing with an insane doctor who told me that God and Tylenol will cure me, I finally got a new doctor who sent me to a neurologist who diagnosed me with a neck hernia or rather, C5 C6 disc herniation. In addition to MRI findings, they also found out that I have Clonus.

I am a little freaked out by the whole ordeal because the neurologist said that my C5 is cutting into my air passage and he believes that surgery is my only option. I am only 30 years old and other doctors (albeit, non neurologist) have told me that I am too young to do this surgery and that I should avoid it.

My biggest concern is the cost of this surgery as I don't know anyone who has gone through it and how much it cost them. I have a full-time job working as a web developer and I do have health insurance (Harvard Pilgrim PPO) and from what I understand, my employer puts in about $1400 every month for my health related needs.

Does anyone on MeFi have any experience dealing with a C5/C6 disc herniation? How much do surgeries like these cost? How long is the recovery time and how long can I expect to be out of work?

Apologies if I threw in too many questions but this neck problem has been destroying my life for past two years and I really want to rectify it so I can go back to feeling normal and no longer passing out from chronic pain.

Thanks MeFi!

posted by bostonhill to Health & Fitness (8 answers total)

First of all, you haven't specified what the surgery is: microdiscectomy? Fusion? There are multiple possibilities. Also, your out of pocket cost depends entirely on your insurance plan. You need to find out more about how much your insurance will cover.
posted by amro at 8:31 AM on April 13, 2014

I know you are probably sick of doctors, but I would seek at least a second opinion before you proceed with surgery. I don't know too many people who have had what they would qualify as great results from spinal surgery.

If you do decide to proceed, it's okay to ask your doctor what it will cost. And your HR person at work can help you figure out how much a surgery like this will set you back out of pocket.
posted by something something at 8:47 AM on April 13, 2014

I had a cervical discectomy performed back in 2011 to remove two ruptured discs, and the total cost came out to around $90,000 (of which my insurance company - Blue Cross - paid $84,000). I was out of work for a total of 5 months.
posted by Telpethoron at 8:53 AM on April 13, 2014

Best answer: Disc herniation or a 'slipped disc' is a really common problem and isn't necessarily something to get freaked out about. Many people have disc herniation and it clears up spontaneously given a month or two and rest. Many people also have disc herniation found 'incidentally' on MRI, meaning that they have a disc herniation but no symptoms from it.

I would nth the suggestion that you must consult with a spine surgeon or two before deciding what to do next. Spine surgeons can either be orthopedic surgeons or neurosurgeons. Find a good spine center near you and get a consultation.
posted by treehorn+bunny at 10:49 AM on April 13, 2014

Best answer: You can usually get an estimate from your insurance company prior to surgery.

I just had a C5-C7 cervical fusion 8 weeks ago and the cost with the surgery, hospital stay and incidentals was around 100k. (I'm in NYC.) I paid roughly $1200 out of pocket. Most hospitals (in my experience) will let you pay over time, interest-free.

I was out of the office 4 weeks and now at the 8 week mark I'm walking 4-5 miles a day and have great range of motion in my neck.

I've had a few spinal surgeries and my doctor has been flexible about payment when I brought it up.

As for being 'too young' - I have a congenital defect in my spine, discovered when I was just over 30. While I'm on the younger end of people seen by my surgeon, I am not the only person my age in there.

While my case is more on the extreme side, I've had great results from my surgeries ( 4 lumbar and my recent cervical fusion.) Surgery has ultimately been my only option but it's not the ONLY option for most people.

I'd definitely see a Neuro or Ortho surgeon to get a more complete understanding of your options. There are many things that can be done before surgery becomes necessary.

Feel free to memail me if you have more specific questions!
posted by carmenghia at 12:15 PM on April 13, 2014 [2 favorites]

In fact, in Massachusetts, your insurance company is legally obligated to give you a cost estimate for the surgery. My insurer (BCBS of Massachusetts) has a form on the member website where you can request a quote.
posted by mskyle at 6:25 AM on April 14, 2014

Harvard Pilgrim is an amazing insurance company to have.

While I can't speak to your situation, I can tell you that their customer service is outstanding and they will go over your plan to the minutest detail with you over the phone. Your company should also have a specific HP rep they work with, and you can always contact that person directly as well.

Their schedule of benefits and cost worksheets are also some of the easiest to follow, so if you know your specific plan number (not your subscriber ID, but the plan number which your company has), then you can google the full sheet. You can also set up an ID on their website's portal and when you login you can review all your benefits yourself.

Much as it's easy to hate insurance companies, Harvard Pilgrim is pretty darn good and really easy to work with and navigate. I'm on the phone with them at least once/month and have received nothing but the clearest explanations and assistance from them.
posted by zizzle at 10:56 AM on April 14, 2014

Don't forget that there will be separate bills for the doctor, the hospital, and the anesthetist. If you ask the doctor how much it will cost, he may only tell you his costs and then you will be surprised when you get 2 more bills.
posted by CathyG at 2:19 PM on April 14, 2014