The cost of two weeks in an pediatric/infant ICU

25 June, 2021

I've decided to share a hospital bill from one of my daughter Sterling's shortest ICU stays. My little girl lost her battle to complications arising from her congenital heart disease on May 11th 2021. Why am I sharing one of her (pre-insurance) bills? Because, why not? If I can't change the issue immediately, I can at least try to bring attention to how insane it's been, in a pandemic, no doubt.

Sterling was born with a rare variant of a heart disease called Hypoplastic Left Heart Syndrome on September 8th, 2020. She was ultimately diagnosed with a very rare genetic condition called Kabuki syndrome at three months old. Like other syndromes, features of Kabuki syndrome can be mild or severe. Unfortunately, Sterling was severely affected by hers.

Sterling was in a pediatric ICU for 207 days, through 4 ICU admissions. Thankfully, we were able to experience life at home with our little girl, albeit not for long. She got to meet her (fur) brothers, her room, her crib, the beautiful sunsets of Lake Michigan/Chicago/Gary, Indiana, bath times, some family, etc.

Sterling Raspe — 2020/09/08 - 2021/05/11

We knowingly walked a fine line with Sterling's condition; even doctors commented on the small amounts of medication Sterling was receiving (such as 0.5ml/hr) were laughable. Sterling was hypotonic, insulinemic and had other endocrine issues. She had only had one functioning kidney, she suffered from moderate/severe hearing loss and hip dysplasia. She had a total of 9 surgeries. She was G (gastro/stomach) and J (jejunum/small intestine) fed. She had tubes in her ears. She received weekly IgG treatments to treat her immunodeficiency, and unfortunately, that isn't even all of Sterling's conditions. Kabuki syndrome affected Sterling much more than that.

The bill I am sharing is from one of our shortest and most unnecessary ICU stays. Sterling was admitted after a regular/scheduled checkup because her blood work showed she had extremely low sodium levels. As we later found out, this was likely caused by my wife and I trying to treat Sterling's reflux, but as we now know, stomach acid contains a lot of your body's sodium.

Not long after we were re-admitted, once the initial admission process calmed down, and Sterling was stabilised, a few millilitres of sodium later, and we were on our way home (for another nine days before being re-admitted again).

After the first bill of $2,500,000+, $260,000 should be a walk in the park... right?

Thank goodness I have insurance, but it didn't stop me worrying knowing that I'm an admission away from potential bankruptcy.

Shout out to the people who lost their jobs during the pandemic (or any other reason) and therefore their insurance, and were either sick themselves or had sick children, because without insurnace (or underinsured), how can/could someone afford this?

Admission at ADVOCATE CHILDRENS HOSPITAL

Blue Cross Blue Shield/Anthem

Pending Insurance*$ 0

* The amount your insurance has not yet responded to. Depending on the response from your insurance, some or all of this amount could become your responsibility.

ItemCost
Pharmacy$ 36,532

 ASPIRIN 81 MG CHEW TAB qty 14
@ $ 1
total $ 14
 ACETAMINOPHEN 160 MG/5ML SUSPENSION qty 10
@ $ 1
total $ 10
 POTASSIUM CHLORIDE 20 MEQ/15ML qty 5
@ $ 11
total $ 61
 MIDAZOLAM 2 MG/ML SYRUP qty 2
@ $ 11
total $ 22
 LOSARTAN 2.5 MG/ML qty 14
@ $ 12
total $ 168
 PEDIATRIC MULTIVITAMIN WITH IRON 11 MG/ML SOLUTION qty 14
@ $ 12
total $ 168
 ALBUTEROL qty 2
@ $ 12
total $ 24
 DEXTROSE 5 % SOLUTION qty 4
@ $ 16
total $ 55
 AQUAPHOR/ZINC OXIDE/AL&MG HYDROX-SIMETH qty 4
@ $ 36
total $ 144
 NYSTATIN 100000 UNIT/GM POWDER 15 G BOTTLE qty 1
@ $ 41
total $ 41
 IOHEXOL 240 MG/ML SOLUTION qty 1
@ $ 47
total $ 47
 LIDOCAINE 4 % CREAM 1 EACH BOX qty 1
@ $ 100
total $ 100
 SODIUM CHLORIDE 4 MEQ/ML SOLUTION qty 18
@ $ 103
total $ 1,854
 AMOXICILLIN 400 MG/5ML RECON SUSP qty 28
@ $ 103
total $ 2,884
 CHOLECALCIFEROL 10 MCG/ML LIQUID qty 14
@ $ 103
total $ 1,442
 FUROSEMIDE ORAL 10 MG/ML SOLUTION qty 11
@ $ 103
total $ 1,133
 CLONIDINE 20 MCG/ML qty 1
@ $ 103
total $ 103
 DEXMEDETOMIDINE 100 MCG/ML SOLUTION qty 1
@ $ 103
total $ 103
 STERILE WATER qty 7
@ $ 103
total $ 721
 MAGNESIUM SULFATE 50 % SOLUTION qty 3
@ $ 103
total $ 309
 CHLOROTHIAZIDE qty 17
@ $ 104
total $ 1,768
 FUROSEMIDE 10 MG/ML SOLUTION qty 16
@ $ 104
total $ 1,664
 POTASSIUM CHLORIDE 0.4 MEQ/ML SOLUTION qty 2
@ $ 104
total $ 210
 SODIUM CHLORIDE 3 % NEBU SOLN qty 33
@ $ 104
total $ 3,432
 ACETAZOLAMIDE 25 MG/ML qty 4
@ $ 104
total $ 416
 OMEPRAZOLE 2 MG/ML SUSPENSION qty 28
@ $ 110
total $ 3,080
 DEXTROSE 5% / SODIUM CHLORIDE 0.9% 5-0.9 % SOLUTION qty 1
@ $ 114
total $ 114
 CHLOROTHIAZIDE 500 MG RECON SOLN 1 EACH VIAL qty 7
@ $ 115
total $ 805
 CALCIUM GLUCONATE IN D5W qty 1
@ $ 115
total $ 115
 CALCIUM GLUCONATE 10 % SOLUTION qty 1
@ $ 117
total $ 117
 SILDENAFIL CITRATE 10 MG/ML RECON SUSP qty 40
@ $ 132
total $ 5,280
 HEPARIN qty 29
@ $ 138
total $ 3,181
 DEXTROSE 25 % SOLUTION qty 1
@ $ 156
total $ 156
 ALTEPLASE 1 MG/ML RECON SOLN qty 2
@ $ 188
total $ 419
 SPIRONOLACTONE 25 MG/5ML SUSPENSION qty 10
@ $ 390
total $ 3,900
 IMMUNE GLOBULIN qty 6
@ $ 412
total $ 2,472
Laboratory$ 17,006

 B CELL SUBSET ANALYSISqty 2
@ $ 36
total $ 234
 POC HEMOGLOBINqty 13
@ $ 41
total $ 533
 LYMPHOCYTE SUBSET PANEL 6qty 4
@ $ 42
total $ 169
 POC METHEMOGLOBINqty 13
@ $ 46
total $ 598
 PHOSPHORUSqty 2
@ $ 47
total $ 94
 SODIUM URINEqty 2
@ $ 52
total $ 104
 UREA NITROGEN URINEqty 1
@ $ 52
total $ 52
 POC POTASSIUM SERUMqty 18
@ $ 54
total $ 972
 GLUCOSE, BODY FLUIDqty 1
@ $ 54
total $ 54
 CHLORIDE URINEqty 1
@ $ 62
total $ 62
 POTASSIUM URINEqty 1
@ $ 62
total $ 62
 C-REACTIVE PROTEINqty 1
@ $ 62
total $ 62
 POC SODIUM SERUMqty 19
@ $ 63
total $ 1,197
 POC CARBON MONOXIDEqty 13
@ $ 72
total $ 936
 OSMOLALITY, URINEqty 2
@ $ 75
total $ 150
 MAGNESIUM SERUMqty 8
@ $ 75
total $ 600
 CBC WO DIFFqty 2
@ $ 78
total $ 156
 CBC W/AUTO DIFFqty 1
@ $ 78
total $ 78
 OSMOLALITY BLOODqty 1
@ $ 83
total $ 83
 GAMMAGLOBULIN, IGGqty 1
@ $ 96
total $ 96
 POC LACTIC ACIDqty 14
@ $ 97
total $ 1,358
 BASIC METABOLIC PANELqty 10
@ $ 106
total $ 1,060
 POC CALCIUM IONIZEDqty 19
@ $ 122
total $ 2,318
 ALPHA-1 ANTITRYPSINqty 1
@ $ 153
total $ 153
 POC BLOOD GASESqty 2
@ $ 160
total $ 320
 COMPREHENSIVE METABOLIC PANELqty 5
@ $ 202
total $ 1,010
 PROCALCITONIN qty 2
@ $ 244
total $ 488
 POC BLOOD GAS PROFILEqty 13
@ $ 254
total $ 3,302
 NATRIURETIC PEPTIDEqty 1
@ $ 281
total $ 281
 RAPID RESPIRATORY PATHOGEN BY PCRqty 1
@ $ 424
total $ 424
Respiratory Services$ 38,290

 CHEST WALL THERAPY SUBSEQUENTqty 15
@ $ 212
total $ 3,180
 CHEST WALL THERAPY INITIALqty 1
@ $ 212
total $ 212
 MECHANICAL CHEST WALL OSCILLATIONqty 56
@ $ 308
total $ 17,248
 RESP TX INITIAL OR SUBSEQUENTqty 33
@ $ 318
total $ 10,494
 VENTILATOR EA ADD DAY PEDSqty 5
@ $ 1,098
total $ 5,490
 VENTILATOR INITIAL DAY PEDSqty 1
@ $ 1,666
total $ 1,666
Radiology - Diagnostic$ 3,556

 XR CHEST 1 VIEWqty 14
@ $ 254
total $ 3,556
Cardiology$ 3,862

 DOP COLOR FLOW VEL MAP PEDSqty 2
@ $ 334
total $ 668
 DOPPLER ECHO F-U/LTD PEDSqty 2
@ $ 451
total $ 902
 ECHO CONGENITAL F-U/LTD PEDSqty 1
@ $ 1,098
total $ 1,098
 ECHO CONGENITAL COMPLETE PEDSqty 1
@ $ 1,194
total $ 1,194
Occupational Therapy$ 722

 PEDS THERAPTC ACTIVITY PER 15qty 1
@ $ 340
total $ 340
 PEDS OT EVAL HIGH COMPLEXITYqty 1
@ $ 382
total $ 382
Speech Therapy - Language Pathology$ 690

 PEDS TREATMENT SP/LANG/VOICEqty 1
@ $ 340
total $ 340
 PEDS EVALUATION DYSPHAGIAqty 1
@ $ 350
total $ 350
Physical Therapy$ 361

 PEDS PT EVAL HIGH COMPLEXITYqty 1
@ $ 361
total $ 361
Medical/Surgical Supplies and Devices$ 31,741.49

 OXYGEN THERAPY DAILYqty 4
@ $ 405
total $ 1,620
 CATH CVC DLUM PED 4F 5CMqty 1
@ $ 646.49
total $ 646.49
 HHF OXYGEN THERAPY DAILYqty 4
@ $ 650
total $ 2,600
 INO PER HOURqty 10
@ $ 2,150
total $ 26,875
Other Imaging Services$ 923

 US BRAINqty 1
@ $ 923
total $ 923
Other Diagnostic Services$ 3,516

 VA ABDOMEN DUPLEX COMPLETEqty 1
@ $ 1,145
total $ 1,145
 VA LOWER EXT DUPLEX BILATERALqty 1
@ $ 1,145
total $ 1,145
 DUPLEX SCAN EXT VEIN BILATERALqty 1
@ $ 1,226
total $ 1,226
CT Scan$ 2,812

 CT HEART W/DYE CONGENITALqty 1
@ $ 2,812
total $ 2,812
Intensive Care Unit$ 126,252

 ROOM CHARGE ICU OR CCU PEDSqty 14
@ $ 9,018
total $ 126,252

How did I get the bill in JSON?

Well, I opened up the hospital's bill in the browser, ran some JavaScript to spit out the contents of the span the item's name was in, as well as the category, and price. Then, I copied them over to Sublime Text, used the multi-line tool, edited each line (simultaneously) to be wrapped in quotes, then keyed the objects/array how I wanted it, finished it off by linting it. As duplicates were in the same bill (such as for different days) and billed under various codes, I used regex to ignore the code difference and finished by grouping the duplicates into one.

What's next?

My wife and I are creating a charity to help bring awareness to the issue, to help sick children and their families, and to try improve the system in whatever way we can... we can use all the help with can get.

https://sterlingstrong.foundation