The average cost of lithotripsy in the United States is $12,800, though prices can range from $7,250 to $16,450.
One factor that can greatly affect the cost of your lithotripsy is whether you have the procedure performed in an inpatient facility, like a hospital, or an outpatient surgery center.
Outpatient centers are just as safe as hospitals but could save you thousands on your medical bill.
Based on our data, the target fair price for lithotripsy is $12,250, whether you have health insurance or not.
- National Average: $12,800
- National Range: $7,250 – $16,450X+
- Outpatient Facility Average: $9,750
- Inpatient Facility Average: $15,825
- Target Fair Price: $12,250
Below, you’ll learn what factors into the cost of lithotripsy, as well as how to find a fair price for your procedure.
Lithotripsy Cost Averages Around the Country
Specific Lithotripsy Procedures and National Cost Averages
Which factors affect the cost of lithotripsy?
Many things can affect the cost of healthcare, regardless of which type of procedure you’re getting. Generally, there are three factors that cause healthcare costs to vary:
- Facility setting — Where you have your medical procedure done affects the cost. Having your lithotripsy done in a hospital as an inpatient costs far more than having the same procedure done in an outpatient center. Since inpatient facilities tend to cost more to run, patients end up paying more for care.
- Insured or uninsured — The price of lithotripsy can vary between insurance providers. The change in price largely depends on how much of the procedure your insurance plan covers if any at all. Furthermore, if you don’t have health insurance, you can expect to pay the full cost of the lithotripsy out-of-pocket.
- Location — The region, state, and even city you live in can affect the cost of your medical procedure. If you live in a rural area with fewer facilities to choose from, you can usually expect to pay more than you would if you lived in a city with many providers. Traveling for a medical procedure can be a great money-saving option.
Inpatient vs. outpatient facility cost differences
The cost of lithotripsy will vary greatly between inpatient and outpatient facilities. The national average cost of lithotripsy at inpatient facilities is $15,825, while the same procedure at outpatient facilities averaged $10,325.
Insured vs. uninsured cost differences
Insured patients have historically paid less than uninsured patients for a lithotripsy, especially when they stay in-network. When a patient has insurance, they share payment responsibility with their insurance company. On the other hand, for patients who don’t have health insurance, the cost of their lithotripsy falls on them and, ultimately, costs more.
In-network vs. out-of-network cost differences
In-network refers to a healthcare provider or facility that has a contracted rate with a health insurance company. This rate is usually much lower than what someone would pay out-of-pocket; also, in-network providers are almost always cheaper than out-of-network providers. This does not apply to patients who are uninsured—without insurance, you shoulder the full cost of your medical procedure.
Payment responsibility
Nearly everyone who has a lithotripsy treatment will have to pay some of the cost out-of-pocket. Uninsured patients will be responsible for the total cost of their surgery.
Patients who do have health insurance will be responsible for paying their deductible, copay, and coinsurance amounts. The amount of each of these costs depends on your health plan.
More factors that affect the cost of lithotripsy
- Prescriptions — A physician may prescribe painkillers or antibiotics post-procedure. To avoid high prescription prices, make sure the prescriptions you receive are covered by your insurance policy. You can also ask if there is a generic version of the same medicine, which can help lower the cost.
- Additional office visits — In some cases, you may be charged a separate fee for an initial consultation with the surgeon before the procedure. Also, your doctor will want to see you for a follow-up appointment in the weeks after your procedure. Additional visits or treatments may be necessary. Ask if these follow up visits are included in the total cost of your procedure.
Your lithotripsy checklist
1. Review the total cost of your lithotripsy with your surgeon. Ask them to explain what each cost is for and keep a record. If you get a medical bill that’s higher than you expected, this information will come in handy.
2. Ask your surgeon if they can perform the procedure in an outpatient setting.
3. Check that all providers are in-network. Sometimes a provider who treats you will be out-of-network (this often happens with anesthesiologists). You can avoid this by asking your surgeon whether all of the providers who will treat you are in-network for your insurance.
4. Ask what the typical cost is if the surgeon finds other areas that need to be repaired during your procedure.
Finding a fair price for your lithotripsy
While the national average for a lithotripsy is $12,800, knowing how much you should pay can be confusing. New Choice Health takes the guesswork out of health care by allowing you to compare facilities and see what the fair price for your procedure is — $8,575 for a lithotripsy. Use New Choice Health’s comparison tool to save money on your kidney stone removal.
