ERCP as sky high expensive as other places?

Hey everyone,

My ERCP is next week which will give me a lot of answers I need to move forward either with PSC diagnosis or just damage to my ducts. I’ve been waiting for 2 months to get it. In that time no one told me about paying up front. I have blue cross blue shield insurance and I’ve already met my deductible. They are saying my procedure is $12,700 and that I have to pay 23% roughly 3150 and 60% is due up front. I’ve had this scheduled for 2 months and only bc I pre registered they called to tell me they WILL not take me unless I pay this up front. It is $1,900.00. I don’t have that money. I’m planning on calling my GI tomorrow for help. I can’t get that together in 5 days. We are driving 6 hours and staying two nights in a hotel on top of it all. It’s at Baylor in Dallas. Couldn’t a local GI do this procedure for half the cost?? I just had an MRCP so why do they need to do more dye and xrays?? I understand the endoscopy part of it but not the X-rays since I just had them 7 weeks ago!!

Hello..

I would say it would be best to pay for someone to diagnose you properly. That alone makes all the difference. We had my fiance's ERCPs done with a local Gastro for several years. He was good. Not great. I feel like we could have had a better long term plan had we gone to the best first and been given the green light to have the simple procedures done elsewhere. I would not want to steer you wrong though... To answer your question, yes a GI doc should be able to preform an ERCP but you don't want just anyone poking around at you and misdiagnosing the issue. If you can put time aside, give BC/BS a call and ask them if your selected doc is the best contracted rate for the procedure. If not, ask who is. If the contracted doc with the cheaper price is sketchy ask for a transfer of care for that specific doc as this appointment is a very important one in your long term health success. Also, you have the right to decide what you want done with YOUR body. If you have already had a specific test, ask for a clear, detailed explanation as to why they need to preform it again. You can always say no. We do it alllll the time. Even in the simplest labs... It's your money, your body. You can ask what tests/labs they want and again, go back to your insurer and ask who is the cheapest contracted provider. I'll be here hoping and praying your situation works out. Keep us posted. Take care.

I agree with Gloria. Since I went into liver failure, my wife and I have been very active in advocating for me, researching everything the Drs say on the internet, asked numerous questions, learning about medicine side effects and interactions. There's no one who cares more about your health than you do, and so unfortunately the Drs aren't always your best advocates.

Are you sure you had x-rays, or are you confusing that with the contrast dye used in an MRCP? If you did have x-rays, what sort were they?

In my area, a specialist is needed for endoscopies. I would only want a specialist. If I were you, I'd focus on getting the best information from the test. You will always forget the money you paid; you will never forget mistakes you made in assessing the credentials of the person/organization doing the work. It seems like a lot of money, and it is, but you really need to take the plunge and get a loan.

Perhaps you can stay more cheaply by looking for a hostel, camping area, or private person willing to host you.

Very wise advice and I agree with you. This morning I was relieved to hear I don’t have to pay up front after all. Thank The Lord, I was so nervous as I know how important a proper diagnosis is. My good friend is dating a guy who has a hepatologist for a dad! He was able to make a call and explain the seriousness of my symptoms. I know it’s the right thing to do! My MRCP I received photos of after the fact so there were X-rays, dye, the whole 9 yards. I’m assuming they will do it again during the ERCP even though it will show the same thing. I guess I’m just wondering why they need to do the dye and xray part again figure that would save me about 3000 right there! 12500 just seems high but I guess that’s to be expected. I’m nervous and anxious but some answers are best with this level of illness. Continue please to pray for peace for me. My spouse is more worried about the financial side of it at this point as we are just now starting our lives together and now dealing with this. I’ll let you guys know how it all goes. Ready to be done waiting after 3 years of continuous strange issues. Thank you for your time and responses and I believe firmly in research and being ones own advocate. The first go round my dr just gave up on me and here I am again hopefully finding out what should have been a few years ago!

FYI, I recently had an ERCP done at the University of Colorado Hospital in Denver and between the procedure itself and the anesthesiologist my insurance was billed $6,700. That’s before whatever discounts my insurance company negotiates.

You need a VERY well trained doctor to do this ERCP. This is not an easy procedure. I have had 3 of them done now and the last two were done under general anesthesia in the OR. My most recent one in August was almost $23,000. I also have Blue Cross. You might try speaking with the accounting department at the hospital for patient assistance or work out a payment plan. When they have asked for money at the day of surgery procedures such as ERCP I just simply tell them I am in process of applying for patient assistance and they let me proceed with the procedure. I wish you the best in all your testing. You will probably feel much better after getting over the ERCP procedure. Just don't make a mistake and eat anything after you leave the hospital till later in the day or you will be throwing it all back up. They do a lot of work in there on those ducts.

Dear Emily,

ERCP is expensive and can show things that MRCP does not. However, the complication rate is quite a bit higher with ERCP. Pancreatitis, infections in the liver, internal bleeding, perforation of the duct, and even death (0.3%). I agree that, if you are going to have it done, find some one who does them often and don't have it done by a GI doc unless he specializes in this procedure. Also, you should check with insurance to see if they have a panel of preferred doc's and hospitals that would not be so expensive.

If you haven't had a liver biopsy, ask the GI doc ( preferably a hepatologist) (if he's reasonably sure that PSC is the diagnosis and the MRCP showed disease) if you could have the biopsy instead. It should be cheaper than ERCP and he would probably order it later, anyway.

Some places do perform ERCP in an outpatient setting, which would save you quite a bit of money. I believe St. Luke's Hospital in St. Louis does this.

After reading the below entries I realize that you may have already had the procedure done. I hope it went well and your diagnosis is no longer up in the air.

Stay strong and I hope this helps,

EAD3

EAD3

I live in New Brunswick. Canada and we are so blessed to have Medicare. If the procedure is ordered and done in the hospital, it is covered by the government. I have Blue Cross and have never used it for any of my procedures. My Blue Cross covers 80% of other medical. Dentist,medications, eye glasses, etc; I am thankful for this kind of coverage. It costs us about $4500.00 in premiums per year, but it is worth it to have peace of mind. My ostomy supplies alone can run into five to six hundred per order every two months.