Lumpectomy Cost

Typical costs:

• For patients covered by health insurance, out-of-pocket costs for a lumpectomy typically consist of doctor visit, lab and prescription drug copays as well as coinsurance of 10%-50% for surgery and radiation. A lumpectomy typically is covered by health insurance.
• For patients not covered by health insurance, a lumpectomy typically costs about $10,000-$20,000 or more. For example, Dartmouth-Hitchcock Medical Center[1] in New Hampshire charges about $10,000 after a 30% uninsured discount, including a doctor fee of about $2,000. Saint Elizabeth Regional Medical Center[2] in Nebraska charges about $5,700-$8,500, not including doctor fees. The hospital charges about $12,200-$17,100 for a partial mastectomy with lymph node removal. Baptist Memorial Health Care[3] in Tennessee charges an average of about $19,000 for excision of a lump in the breast, without complications, not including doctor fees. Kapiolani Medical Center for Women & Children[4] in Hawaii, charges about $12,800 for a partial mastectomy, not including doctor fees, but will reduce the bill to about $7,700 if paid in full within 30 days or $8,900 in 60 days. For a partial mastectomy with lymph node removal, the cost increases to about $16,700 -- or about $10,000 if paid in 30 days or about $11,700 in 60 days.
• In most cases, radiation is used in conjunction with a lumpectomy. According to the Journal of the National Cancer Institute[5] , it typically costs about $7,000 for whole breast radiation and a little about $15,000 for intensity-modulated radiation therapy[6] . Women on a breast cancer forum discuss radiation costs[7] .

• A lumpectomy might be recommended for early-stage breast cancer where there is one small tumor. The patient usually receives either local anesthesia with sedation or general anesthesia, and the surgeon removes the tumor and some surrounding breast tissue and possibly one or more lymph nodes for biopsy, to see if the cancer has spread. The outpatient procedure typically takes about two hours.
• A lumpectomy typically is followed by radiation therapy[8] to try to destroy any cancer cells left behind.
• WebMD offers an overview[9] of lumpectomy and partial mastectomy.

• Breast cancer patients will need regular follow-up doctor visits and screenings to check for recurrence. The American Society of Clinical Oncology offers guidelines for follow-up care that includes doctor visits every three to six months for the first three years, then less frequently, and a mammogram, which costs about $100, every six to 12 months. Patients on a forum at BreastCancer.org discuss[10] the cost of follow-up doctor visits, which can range from less than $200 to $400 or more each.

• Many hospitals give discounts of up to 30% or more to uninsured/cash-paying patients. For example, Washington Hospital Healthcare System[11] in California offers a 35%discount.
• Some state or regional programs offer free treatment. For example, the Commonwealth of Pennsylvania Breast and Cervical Cancer Prevention and Treatment Program offers free treatment[12] to uninsured or underinsured women living in Pennsylvania who meet income guidelines.
• The United Breast Cancer Foundation offers grants[13] to help pay for treatment for qualifying patients, typically those with income below two and a half times the federal poverty level.

• The Society of Surgical Oncology offers a surgical oncologist locator with the ability to search for a doctor who specializes in breast cancer surgery.
• WebMD recommends[14] choosing a surgeon who devotes more than 50% of their practice to breast cancer surgery.
• The National Cancer Institute offers a guide[15] to finding a doctor or cancer treatment facility.
• BreastCancer.org offers a guide[16] to deciding between a lumpectomy and a mastectomy.

1.  patients.dartmouth-hitchcock.org/billing_questions/out_of_pocket_estimator_dhmc.ht...
2.  tp.chi.acelogicus.net/nese/Default.aspx
3.  bolapps.bmhcc.org/estimator/
4.  www.kapiolani.org/women-and-children/my-hospital-bill/uninsured-calculator.aspx
5.  jnci.oxfordjournals.org/content/early/2011/04/27/jnci.djr100.abstract
6.  www.radiologyinfo.org/en/info.cfm?pg=imrt
7.  community.breastcancer.org/forum/70/topic/677765
8.  www.breastcancer.org/treatment/radiation/when_appropriate
9.  www.webmd.com/breast-cancer/lumpectomy-partial-mastectomy
10.  community.breastcancer.org/forum/108/topic/783228
11.  www.whhs.com/about/washington-hospital-discount-policy-for-uninsured/
12.  www.pabreastcancer.org/find-help/patient-resources/commonwealth-programs/
13.  www.ubcf.info/UBCF_Individual_Grant_Application_2009.pdf
14.  www.webmd.com/breast-cancer/news/20070116/finding-best-breast-cancer-surgeon
15.  www.cancer.gov/cancertopics/factsheet/Therapy/doctor-facility
16.  www.breastcancer.org/treatment/surgery/mast_vs_lump

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