Why Would Botox Therapy Treatment Cost $4090.00 for a Single Treatment That Took 15 Minutes?

Question

My wife recently had Botox treatment for persistent migraines. We were then charge a total of $4090.00 for a treatment regimen that took less than 15 minutes. We initially expected an amount of $100-$200, and ended being billed over $800 after the medical insurance paid out the balance (I believe the insurance negotiated for a lower amount), but our copay amount was not reduced accordingly. I will be fighting this as part of a broader fight against Scamerican medical services gone crazy.

Stewart Wang, MD, FACS · Answer

I am sorry to hear about your experience and I understand your frustration with the complex and seemingly illogical costs associated with insurance covered medical treatment. My family member had similar experience like this so even physicians are not immune. The best thing to do it get an itemized bill so you can clearly see where the charges are coming from. This give you something to work with and hopefully can get your charge down to a more reasonable level. With my private pay patients, Botox are charged between $10 to $20 per unit depending on the amount and location of usage. Unless you are billed for other services or used more than 200 units of Botox, I can certainly see why you feel the charges are excessive. In any case, it's perfectly reasonable to discuss your charges with your physician.

	Best Wishes,

Kenneth Hughes, MD · Answer

Some doctors who inject Botox for migraines lose money on the injections, and there are very few who inject with payment from insurance. I would suspect that the insurance barely covered the cost of the Botox no matter what the initial bill appeared to be.

Sam Naficy, MD, FACS · Answer

Without knowing what your itemized charges were, it's very difficult to answer your questions. While the treatment doesn't take very long, cost is not dependent upon time, but number of units. In your case, it sounds like there may be an issue with medical versus cosmetic use and what they're willing to pay for.

Daniel Yamini, MD, FACS · Answer

Dear Gary,

	I sympathizes with your frustrations about the high cost of this treatment.  You definitely need to discuss this bill with your wife's doctor and/or insurance.  As you may know, Botox is purchased by doctors and typically sold based on the quantity (in this case "units") of the product.  Depending on the complexity of the problem being treated and other local market/industry factors, the cost can range between $10 to $20 per unit.  I treat many patients who have migraine as well as cosmetic issues and I rarely use more than 100 units per treatment.  If your wife required over 200 units of the medication, it is remotely conceivable that the charges may approach $4000.   If this was an initial consultation, the doctor may have also billed for other charges such as physician evaluation or examination charges.  You should have them itemize the billing for you; but I do agree that this seems very high.  The good news for your wife is that Botox is a highly effective, safe, and efficient treatment for this debilitating condition.  Best regards. DY

Stephen Prendiville, MD · Answer

Botox is generally charged by the unit. The cost to the Physician is about $6 per unit, and sold to the patient at $10-15 per unit. Since I do not perform Botox for insurance purposes, I cannot comment on your Phyician's charges. $4090 for a Botox treatment does seem excessive.

Why Would Botox Therapy Treatment Cost $4090.00 for a Single Treatment That Took 15 Minutes?

Answers (10)