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.

Item Cost
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 ANALYSIS qty 2
@ $ 36
total $ 234
  POC HEMOGLOBIN qty 13
@ $ 41
total $ 533
  LYMPHOCYTE SUBSET PANEL 6 qty 4
@ $ 42
total $ 169
  POC METHEMOGLOBIN qty 13
@ $ 46
total $ 598
  PHOSPHORUS qty 2
@ $ 47
total $ 94
  SODIUM URINE qty 2
@ $ 52
total $ 104
  UREA NITROGEN URINE qty 1
@ $ 52
total $ 52
  POC POTASSIUM SERUM qty 18
@ $ 54
total $ 972
  GLUCOSE, BODY FLUID qty 1
@ $ 54
total $ 54
  CHLORIDE URINE qty 1
@ $ 62
total $ 62
  POTASSIUM URINE qty 1
@ $ 62
total $ 62
  C-REACTIVE PROTEIN qty 1
@ $ 62
total $ 62
  POC SODIUM SERUM qty 19
@ $ 63
total $ 1,197
  POC CARBON MONOXIDE qty 13
@ $ 72
total $ 936
  OSMOLALITY, URINE qty 2
@ $ 75
total $ 150
  MAGNESIUM SERUM qty 8
@ $ 75
total $ 600
  CBC WO DIFF qty 2
@ $ 78
total $ 156
  CBC W/AUTO DIFF qty 1
@ $ 78
total $ 78
  OSMOLALITY BLOOD qty 1
@ $ 83
total $ 83
  GAMMAGLOBULIN, IGG qty 1
@ $ 96
total $ 96
  POC LACTIC ACID qty 14
@ $ 97
total $ 1,358
  BASIC METABOLIC PANEL qty 10
@ $ 106
total $ 1,060
  POC CALCIUM IONIZED qty 19
@ $ 122
total $ 2,318
  ALPHA-1 ANTITRYPSIN qty 1
@ $ 153
total $ 153
  POC BLOOD GASES qty 2
@ $ 160
total $ 320
  COMPREHENSIVE METABOLIC PANEL qty 5
@ $ 202
total $ 1,010
  PROCALCITONIN qty 2
@ $ 244
total $ 488
  POC BLOOD GAS PROFILE qty 13
@ $ 254
total $ 3,302
  NATRIURETIC PEPTIDE qty 1
@ $ 281
total $ 281
  RAPID RESPIRATORY PATHOGEN BY PCR qty 1
@ $ 424
total $ 424
Respiratory Services $ 38,290
  CHEST WALL THERAPY SUBSEQUENT qty 15
@ $ 212
total $ 3,180
  CHEST WALL THERAPY INITIAL qty 1
@ $ 212
total $ 212
  MECHANICAL CHEST WALL OSCILLATION qty 56
@ $ 308
total $ 17,248
  RESP TX INITIAL OR SUBSEQUENT qty 33
@ $ 318
total $ 10,494
  VENTILATOR EA ADD DAY PEDS qty 5
@ $ 1,098
total $ 5,490
  VENTILATOR INITIAL DAY PEDS qty 1
@ $ 1,666
total $ 1,666
Radiology - Diagnostic $ 3,556
  XR CHEST 1 VIEW qty 14
@ $ 254
total $ 3,556
Cardiology $ 3,862
  DOP COLOR FLOW VEL MAP PEDS qty 2
@ $ 334
total $ 668
  DOPPLER ECHO F-U/LTD PEDS qty 2
@ $ 451
total $ 902
  ECHO CONGENITAL F-U/LTD PEDS qty 1
@ $ 1,098
total $ 1,098
  ECHO CONGENITAL COMPLETE PEDS qty 1
@ $ 1,194
total $ 1,194
Occupational Therapy $ 722
  PEDS THERAPTC ACTIVITY PER 15 qty 1
@ $ 340
total $ 340
  PEDS OT EVAL HIGH COMPLEXITY qty 1
@ $ 382
total $ 382
Speech Therapy - Language Pathology $ 690
  PEDS TREATMENT SP/LANG/VOICE qty 1
@ $ 340
total $ 340
  PEDS EVALUATION DYSPHAGIA qty 1
@ $ 350
total $ 350
Physical Therapy $ 361
  PEDS PT EVAL HIGH COMPLEXITY qty 1
@ $ 361
total $ 361
Medical/Surgical Supplies and Devices $ 31,741.49
  OXYGEN THERAPY DAILY qty 4
@ $ 405
total $ 1,620
  CATH CVC DLUM PED 4F 5CM qty 1
@ $ 646.49
total $ 646.49
  HHF OXYGEN THERAPY DAILY qty 4
@ $ 650
total $ 2,600
  INO PER HOUR qty 10
@ $ 2,150
total $ 26,875
Other Imaging Services $ 923
  US BRAIN qty 1
@ $ 923
total $ 923
Other Diagnostic Services $ 3,516
  VA ABDOMEN DUPLEX COMPLETE qty 1
@ $ 1,145
total $ 1,145
  VA LOWER EXT DUPLEX BILATERAL qty 1
@ $ 1,145
total $ 1,145
  DUPLEX SCAN EXT VEIN BILATERAL qty 1
@ $ 1,226
total $ 1,226
CT Scan $ 2,812
  CT HEART W/DYE CONGENITAL qty 1
@ $ 2,812
total $ 2,812
Intensive Care Unit $ 126,252
  ROOM CHARGE ICU OR CCU PEDS qty 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