Just how much does it cost to have a baby anyway? About $18k by my count.

Having a baby is one of those things in life that is terribly exciting, wonderful and lovely but is also flat-out frightening for a lot of people.

I mean, they're going to send you home with a teeny tiny brand new person!  But beyond all of the new parent anxiety about how not to kill the baby there's the practical side of things: having a baby costs money.  Lots and lots of money.

I'm not talking about diapers or decorating a nursery. I am talking about the physical act of birth and how much it costs in cold hard cash.  So, as a matter of public information and awareness here's what my bill came to and how the doctors, hospital and insurance folks tallied it up.  I know that everyone's costs are different depending on what hospital and doctor you have - this is just a snapshot of my experience.

For those of you who do not wrangle with your health insurance often I hope this provides some insight into how completely ridiculous and grossly expensive medical care is in our country.  It took me HOURS to decipher the stack of claims paperwork so I could put this together. 

The toughest part is that things aren't billed clearly.  For example, often "Lab Services" is a catch-all phrase.  I had to refer to my personal notes to figure out what was being billed for that day.  I also pressed my hospital to give me a further explanation of what, exactly, is covered by a more than $5,000 charge for "Misc Hospital Services."  After several months, emails and phone calls the only thing they could tell me was that it covered a "Normal Vaginal Delivery" and getting even that non-answer was like pulling teeth.

Even after you have all of the claims and bills and adjustments in front of you, it's still a puzzle to figure out what you owe and what's been negotiated and where this claim is in the process and should I pay this now or just wait for my insurance company to process it and if I DID pay it now like they want me to, could I get my money back if my insurance company coughs up some cash?  I DON'T KNOW.

And all of this is not the sort of thing you want to deal with when you have a newborn on your hands. 

**********
Let's start at the beginning.  As with so many adventures that end up at the hospital there's a beginning, a middle and an end.

When I found out I was pregnant I wanted to interview some obstetricians.  Totally normal reaction right?  This person is going to take care of me and my unborn child so I want to make sure I think she's competent and that she's not a crazy "C-Sections for everyone!" kind of doctor.

The thing is, interviewing a doctor is not really something that people do.  It's not something that doctors do or even LIKE to do because (wait for it) they don't get PAID for it.  There's no insurance claims code for "New Patient Interview."  It's (as far as I can tell) not billable and thus Not Worth It.

Isn't it a little disturbing that out of the 8 or so Obstetricians I called none would do an informational interview?  One of the offices I called had to take a message to discuss with the doctor whether she wanted to do "that kind of appointment."  (They never called me back.) 

The 2 physicians I actually visited both billed the visit even though at one all I did was chat with the woman and at the other all they did was a sonogram.  We didn't even SEE that doctor.  She was called out for a birth and, thoughtfully, nobody called to tell her NEW PATIENTS that. (The whole point of us going that day was to MEET HER.  Idiot.)

One was filed under a radiology claim ($193) for the sonogram her tech did.  The other doc billed it as a plain old office visit for $175.

This doesn't mean that I actually PAID almost $400 to interview doctors at my leisure.  No, no, no.  That's just what it was billed to my insurance company for.  By the time they negotiated the rate, paid out their portion and got back to me all I was stuck with was a $35 co-pay for each visit.  (Which the absent doc's office forgot to collect - ha!)

For my purposes we're going to track the billed costs though. Think of it as the sticker price. If you didn't have insurance and access to the negotiated rates this is what they would actually expect you to pay if you couldn't negotiate the costs yourself.

I know that few would end up paying this grossly inflated amount, but I think it's important to view it this way since it's what an uninsured person might have to pay. 

Ready for a trip down the rabbit hole? 

**********

As outlined above, Interviewing Obstetricians: $368

Prenatal Care

Month 3

• Office Visit - $200
• Sonogram - $220

Month 4

• Office Visit - $200
• Sonogram - $220
• Tripel Panel Screen - $420

Month 5

• Sonogram - $300 (no idea why they suddenly got more expensive)
• Office Visit - At this point they stopped billing them individually.  They'll bill those cumulatively with the cost of delivery after the baby is born.

Month 6

• Sonogram - $200

Month 7

• Glucose Tolerance Test - $149
• Rhogam Shot - $135

Month 8

• Group B Strep Test - $83

Month 9

• Sonogram #1 - $200
• Sonogram #2 - $200
• Sonogram #3 - $200
• Non-Stress Test #1 - $185
• Non-Stress Test #2 - $185

Pre-Natal Care: $3,097

Obstetrician's fee for delivery - $3,000

Hospital Costs for Mom

• Attempted Induction - $498.25 
  • (We went to the hospital, they hooked me up to a monitor, I decided I didn't want to be induced that day after all, we went home.  Most expensive two hours of fetal monitoring EVER.)

• Day 1 blood work - $55.75

• Epidural - $1,020
  • I thought it was nice that even though she had to do it twice, I only got billed once.


• Room and Board - $2,775
  • $925/night.  I would expect more swanky accommodations for that much money.  Also annoying since I made Chris get me dinner every night from somewhere else.  And the bed was not comfortable.  No bathroom toiletries.  And the towels?  SUCKED.  I've stayed in Holiday Inns that were more comfy.  Although Holiday Inn did not have narcotics on demand so maybe it wasn't so bad.


• Misc Hospital Services - $5,375.94
  • Exactly what this covers I have no idea.  I hate seeing "Misc" on any kind of insurance claim.  Presumably this covers the fee to have nurses look after me and any supplies I use like my awesome hospital cup pictured here.

• Day 2 blood work - $15


• Lactation Consultant Visit - $113.25
  
  • We went back on her 4th day for a weight check and they watched me nurse her, pronounced I was doing it totally right (which I knew) and then billed me more than a hundred bucks for it! 
  • The most irritating part of this was that I had NO IDEA this would be billed separately from my hospital stay.  When the nurses told me to show up for it they made it sound mandatory.  This is perhaps my biggest gripe: nobody wants to tell you that something will cost money or how much it will be. 

One 3-night visit to the hospital to birth a baby: $9,853.19

Hospital Costs for Baby

• Room and Board - $1,560
  • Am I the only one that finds this hilarious?  I breastfed her, she slept in a plastic bassinet, used maybe 20 diapers in the day and a half we were there after she was born and we took 4 blankets home with us.  $1,500 for THAT?  Damn.  I should have asked for more blankets.

• Misc Hospital Services - $469.28
  • AGAIN with the vague description. 

• Blood work - $52.50


• Day 1 pediatrician visit - $138

• Day 2 pediatrician visit - $115
  • I have no clue why a second visit is cheaper.  Also interesting to note is they are billed as one hour visits and I HIGHLY doubt he spent an hour with her both days.

• Optional Misc Services - $38.25
  • This was a visit with the lactation consultant where they weighed her.  When the nurses told me to come back in two days for this, I didn't know it was going to be billed separately.


• Lab work - $24.25
  • This is the cost for a jaundice check when we were with the lactation consultant getting her weighed.  Again, had no idea it would be billed separately.

• Additional Metabolic Screening - $66
  • Your state will only do a limited screen - for an additional fee you can have your baby screened for far more disorders with a simple blood test.

Welcome to the world baby girl!  $2,463.28

********

Total cost?  $18,781.47

Are you surprised?  Or did you think it would be more? Do you think it's too much to charge?  Or just about right? 

I would love to hear what you guys think.

Comments

[Naomi H. Lord]

The total is staggering; I had been wondering and appreciate your sharing. Makes the $190 for annual physical I pay not so bad. Medicare does not cover this yearly visit since I take no prescription medicines.
In 1955 OB charged us $200 for prenatal care(special rate since we were in Army); hospital was about $500 for our 5 days there.
Grandmother

[Holly]

I'm curious - what was the negotiated rate that your insurance actually paid to the hosptial/doctors etc? I know when Bert had his horrible accident (which involved 7 fractures in his back, multiple medical air transports etc) we were billed for about $50K in the US - the initial stuff was in Canada, and I don't count their costs. So, $50K was for all his care a full 7 days after the accident happened. Guess what insurance paid? $18K, and called it even. Amazing.

So, my theory is that they ALWAYS overbill to the extreme, knowing that the insurance will only pay, say 35% of the costs, so that in the end all the hospital wanted was $18K, so they overinflated the charges accordingly. Of course, that totally screws over anyone who is paying cash.

[Manda]

How about this ... I got a bill just from my physician (I only owed $84 ... we paid about $1500 for our deposit), for upwards of $28,000. That was just for hospital costs!! HOLY CRAP. That is not including any of the baby's care or anything prenatal OR anesthesia. Granted I had an induction, plus a full day's worth of labor, AND THEN a c-section (the c-section is itemized at $3,000) but OH MY GOSH. That is craziness.

[Julia]

The cost of health care these days is ridiculous. My mother had to be in the hospital for about a month before she had my brother. There were a lot of issues with his birth. All in all, I think the costs were somewhere around 50K (no joke). I wouldn't be surprised if my parents are still trying to pay that off.

[Mom]

You were a bargain! Giving birth at the Naval Hospital Camp Pendleton we paid for my meals. Which I remember totaled to about $21.00 for 3 days. I did have to change my own sheets and was in a room with 3 other ladies. I was really ready to go home and rest.

[Emilie]

I still can't believe the price! I live in Canada and we pay 0.00$ for any medical service. I find this shocking.. I never realized how expensive it is for Americans to get basic care.

[Mom]

Oh Emilie, You pay 0.00$ for any medical service. How much do you pay in taxes? and how quick can you get those services?

[Melissa]

My hospital stay for 4 days totaled just a bit shy of $28,000 for a "normal" vaginal delivery. I almost fell over when I saw the total. Wanted to say, wait put him back....I can do this at home.
The best part of hospital bills are all the things that they charge you for that you don't use. I got to pay $15 for an amni-hook that never made it out of the plastic it was wrapped in. Should have taken that thing home with me! LOL!

[Emily]

Hey, do you know anything about child care costs out there??? Help? Anybody?

[Sarah in Ottawa]

A'Dell,

I am reading through your older posts and this is SHOCKING TO ME. Like Emilie above, I am a Canadian. My marginal taxation rate is only slightly higher than the US averages (based on info from the IRS website), and our property taxes are NOTHING like rates charged in Texas. I had a hospital birth with my son just under one year ago, and we paid for PARKING. I was able to get in with an obstetrician, then a midwife (I preferred the latter's quality of care) with no waiting, and it is all covered via our provincial health insurance. While the number of sonograms covered was 3 (I could have had more, paid by me and reimbursed by benefit coverage from work), that seemed sufficient.

One of my best friends is American and has a Master's in Public Health; she now works for one of the big health care guys (KP). The crap I hear about the US health care industry makes my head spin. And there are so many misconceptions about the Canadian system. We do have problems with wait times for surgeries considered non-essential (like knee replacements for people in their 60s), but if you have a genuine health issue? Speedy and professional service is provided.

No system is perfect but wowza! Thank goodness for your coverage!

[babyhawk oh snap]

Believe it even poor people have babies in an economical way so its each to its own.

[coach handbags]

How many people actually have 8 true friends?Hardly anyone I know.But some of us have all right friends and good friends.