A pulmonary embolism is a blockage of an artery in the lungs, often caused by a blood clot that has come from another part of the body, such as the legs. A pulmonary embolism can be fatal, so it is necessary to seek emergency care immediately.
Typical costs:
For patients covered by health insurance, out-of-pocket costs for a pulmonary embolism typically would include a copay or coinsurance of 10%-50%, prescription drug copays, follow-up doctor visit copays and laboratory copays. Health insurance typically covers treatment for a pulmonary embolism.
For patients not covered by health insurance, treatment for a pulmonary embolism typically costs $15,000-$40,000 or more, depending on the length of hospital stay and whether there are complications. For example, Saint Elizabeth Regional Medical Center[1] in Nebraska charges $12,500-$29,500 for treatment for a pulmonary embolism without major complications, depending on the individual case and length of stay, not including doctor fees. St. Mary's Hospital[2] in Wisconsin charges about $15,000. And Baptist Memorial Health Care in Tennessee charges about $20,500 without major complications and about $37,000 with major complications, not including doctor fees. According to the American Thoracic Society[3] , average total per-incident medical costs for pulmonary embolism are about $30,000.
First, doctors will work to stabilize the patient and confirm diagnosis. Initial treatment might include placing the patient on a heart monitor and administering oxygen and medication to raise blood pressure.
Typically, the blood-thinning medication heparin[4] is administered intravenously to stop more blood clots from forming. Another blood-thinning medication, enoxaparin[5] , might be given by subcutaneous injection. Another medication, warfarin[6] , typically is given orally. It usually takes a few days for warfarin levels to reach an appropriate therapeutic dose. In cases in which a patient is severely ill and not responding to treatment, a drug such as urokinase[7] might be given by injection to break up existing clots. The required hospital stay can range from two to three days to a week or longer.
eMedicineHealth.com offers an overview of pulmonary embolism treatment[8] .
Additional costs:
After discharge from the hospital, the patient typically will be placed on an anti-coagulant drug -- typically warfarin (brand name Coumadin) to help prevent blood clots. For a one-month supply, Drugstore.com charges about $15-$25 for the generic and $50-$70 for the brand name drug.
Lovenox[9] or Arixtra[10] -- both injectable anti-coagulant drugs -- might be prescribed temporarily, along with warfarin, until the warfarin reaches therapeutic levels in the blood. Drugstore.com charges more than $700 for a one-month supply of Lovenox and $1,600 or more for a one-month supply of Arixtra. Insurance often covers these drugs when medically necessary, such as for patients who cannot take warfarin.
Patients on anti-coagulant drugs require regular monitoring -- for example, for warfarin a PT (prothrombin time)/INR (international normalized ratio) test[11] , as frequently as once per week, to make sure the drugs are working effectively. This typically costs $6-$25 per test at a doctor's office or laboratory, or can be done as a home test[12] with the purchase of tests strips and a machine that costs $1,500-$2,500.
Depending on the individual case, and if there is an underlying condition -- such as cancer or heart disease -- or recurrent pulmonary embolism, the patient might require extensive follow-up care and monitoring that could cost thousands, or tens of thousands, of dollars.
Discounts:
Many hospitals give discounts of up to 30% or more to uninsured/cash-paying patients. For example, Washington Hospital Healthcare System[13] in California offers a 35% discount.
The manufacturer of the anticoagulant drug Coumadin, Bristol-Myers Squibb, participates in the Together Rx Access[14] program, which offers discounts of 25%-40% on certain drugs. The manufacturer of Lovenox, Sanofi-Aventis, offers the drug for free to uninsured patients who qualify on a case-by-case basis, through its patient reimbursement program[15] .
Shopping for pulmonary embolism treatment:
The U.S. Department of Health and Human Services offers a hospital comparison tool[16] that lists hospitals near a chosen zip code and whether they offer emergency services.
A family doctor and pulmonologist -- a board-certified internal medicine[17] doctor with additional training in lung diseases -- can provide follow-up care. Depending on the individual case, and whether there was an underlying cause, such as cancer, for the pulmonary embolism -- other specialists might be needed for ongoing care. These could include a hematologist -- a board-certified internal medicine doctor with additional training in blood disorders -- or an oncologist, cardiologist or thoracic surgeon.
The American Medical Association offers a doctor finder[18] by location and specialty. It is important to make sure any specialist you are considering is board-certified[19] .
Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
10 Quick and Inexpensive Home Makeover Projects To Do While At Home You may not be able to host the large family gathering for the holidays, but there are still many ways to pick up items curbside to spruce up your indoor space for your everyday enjoyment and to bring a more festive spirit. || Posted December 30 2020
10 Key Ways to Prepare for Extreme Snow Forecasters are predicting a true nor'easter will hit the eastern and central states with rain, thunderstorms, ice, snow and high winds over the Thanksgiving weekend. It's crucial to plan ahead, before bad weather hits. || Posted November 26 2013
In hospital 7 days, small PE in lung, 1 extra day because they took me off heparin for almost a day before putting another bag on. $66,700 seems way too expensive! That would pay a nurse's salary for a year.
CostHelper is based in Silicon Valley and provides consumers with unbiased price information about thousands of goods and services. Our writers are experienced journalists who adhere to our strict editorial ethics policy.
CostHelper Community
shoulder mri Paid: 8000.00 Seriously, 8K for an MRI before all the secret insurance kicks in. I was stuck with a 1200 bill and my insurance is pretty good. This is insane for a 20 minute procedure with no nurse assistance... [more]
what should have cost under 100 Paid: 399.67 had my back wheel stuck on someone's driveway and I was pulled out as easily as a tractor could have done... [more]
Why is dental insurance stuck in the 80's? Paid: 55000.00 In 1986, I started my first full time Big Girl job, which came with options for medical insurance that ranged from "Volkswagon to Cadillac, and everything in between" which was up to me to choose based on my needs, what I could af... [more]