When health insurers contract with providers, they agree on prices for all kinds of procedures. For a lumbar laminectomy, a common spine surgery for ailments like herniated discs or arthritis, the median price is $1,400.
Out-of-network providers, those that don’t contract with health insurers, are getting 24 times that amount for the same surgery at the median — nearly $34,000 — through the No Surprises Act’s arbitration process. Some are even getting north of $100,000.
The lumbar laminectomy is just one example of the extraordinarily high awards being doled out under the flawed system created by the 2020 law. The law has successfully protected patients from unexpected bills, but it’s also been a major boon for providers. They’re not only securing massive sums when they win, but they’re also prevailing in over 80% of disputes.
