Insurance and Financial Considerations for Pilonidal Surgery

pilonidal surgery

The diagnosis of a pilonidal cyst is sure to make one feel nervous. Besides bearing the excruciating pain, the recommendation of a pilonidal surgery is generally hard to accept. The pre and post-procedure cost of treating pilonidal disease comes across as an additional burden. But thankfully the expenses of pilonidal cyst removal surgery are covered under insurance, helping you easily manage the financial aspects. Here’s what you need to understand about pilonidal cyst surgery cost for more effective management:

Total Cost Of Pilonidal Cyst Removal Surgery?

The total cost of a pilonidal cyst removal can fall between $500 to $10,000 or more. This huge variation in the cost is simply because of the complexity of the case. For simple incisions and conservative treatments, the doctor’s charge may range from $500 to $2,000. For more complex cysts that require excision treatment, the cost ranges between $3,000 to $6,000. For specialized flap surgeries to treat stubborn and recurrent cysts, the expenses are still higher. 

Factors That Influence Surgery Cost

During the initial consultation with a healthcare provider, the doctor will assess and evaluate the case closely to chalk out the best possible treatment plan. The total cost of the surgery will be a combination of various factors. These include:

Complexity of the case – Superficial cysts can be treated with minor incision and drainage. But in cases where pilonidal cyst extends to and infects the sinus cavity, more invasive surgery is required. 

Type Of Surgery – Open wound procedures cost the least. However, if the healthcare provider contemplates a closed wound procedure, the charges scale higher. The surgery cost is the highest for procedures like the rhomboid flap technique that removes the infected skin with a specific type of excision. 

Surgeon’s Experience And Qualification – While a general surgeon can perform a pilonidal cyst removal surgery, a colorectal surgeon is the best trained and equipped for the procedure. Board-certified surgeons charge more but promise the best care and treatment outcomes.

With or Without Insurance Cover – Patients who are without insurance generally have to shell off a higher amount from their pockets. Insurance covers also do not cover the entire bill amount. Check for out-of-pocket costs like deductibles and copays.  

Post-Procedure Follow-ups – Established surgical centers include charges of post-procedure follow-up visits and medical care in the total bill. It is an important part of the entire treatment process.

Geographic Location – The location along with infrastructure and facilities offered by the clinic come into play when estimating pilonidal cyst removal cost. 

Understanding Insurance Cover

Financial cover for the pilonidal disease is available under most healthcare plans. However, different insurance providers have different policies for deductibles, copays, and reimbursement rates. It’s advisable to take pre-approval for surgery and use in-network insurance providers for smooth claims and cashless treatment. 

Final Thoughts

Pilonidal surgery is the most effective treatment for the removal of painful cysts. But the cost consideration is an important factor to be considered. After the initial consultation with the surgeon, one has a clear idea of the potential cost. Avail insurance coverage and make suitable arrangements for post-treatment expenditure to sail through the situation comfortably. Dr. Allen Kamrava MD MBA is one of the most trusted colorectal surgeons in Beverly Hills. With tie-ups with all major healthcare insurance providers, the medical bills and treatment costs no longer remain a cause of concern. 

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