The average cost of surgery depends on the type of procedure you are having, where you live, and what kind of coverage you have (if any). Keep in mind that you can usually negotiate a fee discount if you pay in cash or by credit card.

Cost Overview Table (USD)

Procedure Type	Typical Price (Before Insurance)	Reported Out-of-Pocket (Patients)
Incision & Drainage (I&D)	$600 – $1,100	$800 – $2,500
Excision (Open or Closed)	$3,000 – $5,600 (avg)	$3,000 – $9,000
Cleft Lift / Flaps	$5,000 – $9,000+	Similar range based on patient quotes

Keep in mind that these are ranges; your location could be much higher or lower. Hospital costs also vary widely, and billing errors are common. If the costs seem completely out of line, call your insurer.

Can You Haggle With Your Doctor?

The idea of haggling with your doctor over the cost of surgery may seem unconventional. Still, in the current landscape of American healthcare, it’s not only possible—it’s often a necessary and effective strategy for managing high medical expenses. While the approach is more of a negotiation than a traditional haggle, proactively discussing and questioning costs is no longer old advice but a crucial step for any patient facing a surgical procedure.

Success, however, depends on being informed, polite, and persistent. Negotiations typically take place with the surgeon’s billing office or the hospital’s financial department, rather than directly with the surgeon in the exam room. However, the conversation often starts with the doctor.

Why You Can (and Should) Negotiate

Several factors in the healthcare system make negotiation possible:

• Complex and Opaque Pricing: The prices hospitals and doctors list (the “chargemaster” rate) are often inflated and do not reflect what insurance companies typically pay. This discrepancy creates room for discussion, especially for uninsured patients or those paying out of pocket.
• Prompt-Pay Incentives: Healthcare providers value immediate payment. The administrative cost and uncertainty of collecting from insurance companies or chasing patient debts make a lower, guaranteed upfront payment attractive. Many are willing to offer significant “prompt-pay” or cash discounts.
• Competition and Market Rates: With tools now available to research the “fair market price” for procedures in your area, you can approach negotiations with data, giving you leverage to ask for a price that aligns with regional averages.
• Financial Assistance Programs: Many non-profit hospitals are required to have financial assistance or “charity care” policies. Even for-profit providers often have programs to help patients who are facing financial hardship.

A Step-by-Step Guide to Negotiating Surgery Costs

Negotiating effectively requires a strategic approach. Here’s how to navigate the process before and after your surgery.

Phase 1: Before the Surgery (Proactive Negotiation)

This is the most effective time to have these conversations.

Phase 2: After the Surgery (Reactive Negotiation)

If you couldn’t negotiate beforehand or you’ve received a bill with unexpected charges, you still have options.

1. Don’t Pay Immediately: Wait until you have reviewed all the documents. Paying a bill can sometimes be seen as an acceptance of the charges.
2. Scrutinize Every Document:
   • Request an Itemized Bill: This will break down every single charge, from medications to facility fees.
   • Compare with Your EOB: Cross-reference the itemized bill with the Explanation of Benefits (EOB) from your insurer. Look for common errors, such as duplicate charges, incorrect billing codes, or charges for services you didn’t receive.
3. Dispute Errors and Overcharges:
   • Contact the Billing Department: Politely point out any errors you’ve identified. If you believe a charge is excessive based on your research, challenge it.
   • Appeal with Your Insurer: If your insurance company denied a claim you believe should have been covered, file a formal appeal.
4. Revisit Negotiation Tactics: Even after the fact, you can still ask for a reduction in your remaining balance. Explain your financial situation and offer to pay a smaller, lump-sum amount to settle the debt. Many providers would rather receive a partial payment than risk sending the bill to collections.

Why Costs Vary

• Clinic vs. hospital charges
• Surgical technique & complexity
• Geographic region and provider billing practices
• Insurance plan design and deductibles

What Goes Into the Costs?

• Surgeon’s Fee – ask, and they will tell you. The surgeon’s fee usually covers the cost of performing the surgery and post-surgery visits while you are healing.
• In US medical billing, there are 6 general codes that determine billing for a surgeon, called CPT codes. The American Medical Association sets these up. The Fair Health website will give you basic ranges (for US patients) of average surgeon fees in your area for these coded procedures (use Pilonidal as your search keyword, or search by the 5-digit code below).
  • 11770 Simple Pilonidal Excision
  • 11771 Extensive Pilonidal Excision
  • 11772 Complex Pilonidal Excision
  • 14301 Cleft Lift (Adjacent tissue transfer or rearrangement)
  • 10080 Simple Lancing (incision & drainage)
  • 10081 Complex Lancing (incision & drainage)
• Anesthesiologist Fee: The surgeon’s office can tell you what it will be.
• Surgical Center Fee – your surgeon’s office should also be able to give you a good idea, or you can talk to the administrative offices of the surgical center. The surgeon’s and anesthesiologist’s fees are straightforward; creative accounting starts at the hospital. If you are paying cash and watching the pennies, this is where you want to focus on. The more up-front work you do in asking about costs and demanding information, the less of a surprise the bill will be afterward. Start your fight to control costs BEFORE your surgery.

Tips to Manage Cost

• Request itemized cost estimates before surgery
• Ask about bundled cash rates or upfront discounts
• Use cost comparison tools like MDsave
• Negotiate or set up a payment plan with providers
• Apply for charity care or hospital assistance if uninsured

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