Am I being overcharged for intracanalicular plugs?

[chrisdab]

Hi, I'm trying to get relief from my dry eyes 2 years post lasik. I am looking into Lacrimedics but the only doctor the company says currently uses them in the DC area charges $400 while they cost $75 directly from Lacrimedics. Is this normal for intracanalicular plugs? It seems like I'm being overcharged just because it says "long term". I dont have insurance to pay for it.

thanks

[calli66]

My eye doctor charged $295 per eye to insert temporary collagen plugs (duration 3-5 days). I thought the price was too high, and my insurance, which is excellent, only paid for part of it. The cost includes the price for the plug plus insertion.
The procedure is coded as "surgery" which seems like an inaccurate description. I mean, if a doctor inserts something in an opening, such as a cotton plug up the nostril, does that constitutes "surgery," too?
C66

[Rebecca Petris]

There are some threads in the Plugs forum about the wide variety of charges for plugs, including this one - worth browsing. Some doctors charge a lot more than this, actually.

The procedure is coded as "surgery" which seems like an inaccurate description.

Sounds funny maybe but... it's invasive, and carries risks. Hence the pricing (and the wide range).

[chrisdab]

Thanks so much.

[kitty]

If you have insurance, you will find out that your eye doctor might charge a big price, but in reality will only get reimbursed a small portion, especially if he/she is a preferred provider with your health plan. I had Lacrimedics 3-day, semi permanent and permanent plugs in all fours this last year. I'm looking at my last statement right now, when I got permanent upper plugs put in. The price is about the same as for the others. 2 upper plugs were billed at $711 (a bit over $300 each). They were discounted to 406.14 ( a little over $200 each). The cost of care was 304.86. The health plan paid my doctor $289.86. I paid my $15 co-pay and the rest was written off. The entire thing comes out to about $152.43 per plug including co-pay. I am so very happy that I got the rest of the permanent plugs done last year, as my co-pay this year goes up to $50, which is more than the usual cost of an office visit at full price.