Why Is This Implant or Screw So Expensive?

Medical implants, hardware, and surgical supplies (like screws, rods, or plates) are often billed at extremely high prices in U.S. hospitals. The reasons include:

• Hospital Markups: Hospitals purchase implants from manufacturers, then bill them to health plans with markups that can be several hundred percent.
• Lack of Regulation: Unlike in other countries, the U.S. has no consistent caps or reference pricing for medical devices.
• Opaque Supply Chains: Pricing is hidden from employers, patients, and often even from surgeons who use the hardware.
• Revenue Strategy: Hospitals treat implants as profit centers, bundling inflated device charges into overall surgical claims.

How Self Fund Health Addresses This

• Preferred Providers: We partner with independent surgeons and surgical centers that use implants at transparent, fair prices (typically averaging 200% of Medicare or less).
• Steerage: Our DPCs and Nurse Navigators guide members toward these Preferred Providers, avoiding the inflated hospital markups.
• Stop Loss Alignment: Demonstrating that members are steered to fair, transparent implant pricing strengthens our case with stop loss underwriters.

Key takeaway: Implants and surgical hardware are expensive because of hospital markups and opaque pricing. Self Fund Health doesn’t buy implants directly—we solve the problem by steering members to Preferred Providers who keep implant costs reasonable and transparent.