What is the Average Cost of a Surgical Procedure in Southern California?

Learn about how much a surgical procedure may cost in Southern California including information about insurance coverage and other payment options.

What is the Average Cost of a Surgical Procedure in Southern California?

The cost of medical procedures can be overwhelming, especially for those without insurance or with limited budgets. It's no surprise that 60-65% of all bankruptcies are related to medical expenses. The best way to deal with hospital bills is usually through employer-provided insurance, but if you don't qualify, Medicare and Medicaid can provide substantial help. The Affordable Care Act also offers coverage, with monthly premiums based on income.

When it comes to hospital and surgical costs, being an educated medical consumer and exploring sources of funding are key. There is no standard system for determining what a hospital charges for a particular service or procedure, as many factors influence the price. These include the patient's health circumstances, laboratory tests, x-rays, medications, and physician and specialist fees. The cost of surgery can vary greatly depending on the type of surgery and other factors, such as whether the patient stays in an intensive care unit (ICU) or recovery room.

The location of the hospital and who pays the bill also affect overall costs. Patients may think they know the real cost of surgery, but there are often additional expenses that aren't absorbed until after the fact. Even with the No Surprises Act, supplements can be a big surprise when the bill comes. Self-employed individuals or those without employer-provided insurance can get private insurance through the Affordable Care Act.

Other public health insurance options include CHIP, VA and DoD programs, workers' compensation, and other state and local third-party payers. Patients may have to pay copays, deductibles, or the full cost of hospital care and surgery. Those having trouble paying their medical bills should talk to a nonprofit credit counselor to discuss debt relief options. Health insurance will usually cover 90% or more of hospital stays and surgeries.

Insurance reduces costs by negotiating rates with providers and paying much of the bill for you. Knowing what your insurance covers and what your costs could be without it will help you afford hospital costs. Even with the No Surprises Act, it can be difficult to determine what the costs will be. To get the best deal, compare prices as vendor costs vary a lot.

Make sure the provider complies with the No Surprises Act so you understand what you'll have to pay. Calculate all expected expenses including surgeon's fees, anesthesia expenses, hospital care before and after surgery, laboratories, medications, x-rays, tests, and doctor visits. Plan for contingencies that can increase costs. If you don't have insurance or are undergoing an uncovered procedure such as weight loss or plastic surgery, you should be your own advocate.

Establish what your payments will be and talk to your provider about reducing costs if necessary. If you can't pay your medical bills never ignore calls from the hospital; billing departments can help set up payment plans and allow you to pay rates negotiated by insurance companies. There are creative ways to cover the cost of surgery if you're not insured or not covered by your plan; these include payment plans through providers and crowd-funding sources such as GoFundMe. Home equity loans are another option if you have good credit and capital; however if you can't make payments this could show up on your credit report as a negative account.

Investing your life savings in surgery is not ideal but if it improves your quality of life it could be money well spent.