The Price of Steroid Injections Exposed

July 4, 2024

Get the facts on how much do steroid injections cost, from types to trials, and insurance coverage.

Understanding Steroid Injections

Steroid injections, commonly known as cortisone shots, are used in the treatment of various health conditions such as joint inflammation, arthritis, and skin conditions. However, understanding the costs associated with these injections is essential for patients considering this treatment option.

Cost Overview

The cost of cortisone shots can vary significantly, ranging from $25 to over $1,000 Healthline. According to Sesame Care, the cost typically falls between $100 and $300. However, the exact cost depends on several factors, including the patient's insurance coverage, the specific facility, and the body part receiving the injection.

For instance, a cortisone shot used to treat deep acne may cost between $25 and $100, while an epidural steroid injection for lower back pain can cost between $100 and $300. These costs may include additional services such as the office visit, medical imaging (like X-rays or CT scans), and the procedure itself.

Please note that these are estimated costs and it's recommended to discuss the specific costs with the healthcare provider before undergoing the injection.

Insurance Coverage

The cost of steroid injections can be significantly impacted by a patient's insurance coverage. For those with insurance, the out-of-pocket cost for a cortisone shot can range from $20-$50, depending on the number of shots needed and whether the shot is deemed medically necessary by the insurance provider Sesame Care.

Patients without insurance or those who are underinsured may end up paying more. However, according to Medicare reports, patients pay an average of $84 for injections of therapeutic substances, such as cortisone, when performed at a non-hospital facility. The average price at a hospital is $146 Healthline.

Overall, the cost of steroid injections can vary widely based on several factors. It's essential for patients to understand these costs and how their insurance coverage may impact them, to plan appropriately for their treatment.

Specific Injection Costs

Understanding the costs associated with different types of steroid injections can help individuals budget effectively for their treatment. Here's a closer look at the costs for various steroid injections.

Cortisone Shots

Cortisone shots are a common form of steroid injection used to reduce inflammation and pain. The cost for cortisone shots can vary significantly, ranging from $100 to $300, and in some cases exceeding $1,000.

Insurance coverage can significantly impact the cost. For example, patients under Medicare pay an average of $84 for injections of therapeutic substances, such as cortisone, when performed at a non-hospital facility. In contrast, the average price at a hospital is $146 [1].

Epidural Steroid Injections

Epidural steroid injections are often used to alleviate back pain. A single epidural steroid injection may cost up to $600. Insurance coverage for this type of injection is often contingent on it being medically necessary and meeting the medical guidelines of the insurance provider [2].

Facet Joint Injections

Facet joint injections, another form of steroid injection used to manage back pain, can range from $1,000 to $1,600 per injection. Similar to epidural steroid injections, insurance may cover part of the treatment if it's deemed medically necessary and aligns with the insurance provider's policies [2].

Ultrasound-Guided Steroid Injections

Ultrasound-guided steroid injections are often used to treat conditions such as Morton’s neuroma. The cost of this type of injection is approximately £149 (around $200). The average cost of National Health Service resources over three months following the injection was £280 (around $370) for intervention participants and £202 (around $270) for control participants.

Here's a summary of the costs associated with each type of injection:

Injection Type	Cost Range
Cortisone Shots	$100 - $300+
Epidural Steroid Injections	Up to $600
Facet Joint Injections	$1,000 - $1,600
Ultrasound-Guided Steroid Injections	Around $200

Please note, these costs are averages and actual costs may vary based on factors such as location, provider, and insurance coverage. Always consult with healthcare providers and insurance companies for the most accurate cost information.

Assistance Programs

While steroid injections can be a crucial part of treatment for many individuals, the cost can often be prohibitive. Luckily, there are several programs available that can help mitigate the expense, including Drug Assistance Programs and Copay Assistance Programs.

Drug Assistance Programs

Drug Assistance Programs (PAPs) are offered by various entities such as pharmaceutical companies, state programs, and nonprofits. These programs provide free or low-cost medicines for individuals without insurance or who are underinsured and cannot afford their medication. The eligibility criteria for such programs typically include not having health insurance, having insufficient health insurance for medication coverage, or meeting specific requirements [4].

While the Asthma and Allergy Foundation of America (AAFA) does not directly provide funding for medicines, they do provide a comprehensive list of organizations and programs that may assist in covering the cost of medicines. This includes drug company assistance programs, pharmacy drug savings programs, nonprofit copay and premium assistance programs, and state drug assistance programs [4].

Certain medications, like IV Solu-Medrol, a high dose corticosteroid given by intravenous infusion for MS relapses, do not have patient-assistance programs as they are not patented. In such cases, uninsured individuals are advised to check with the facility providing the infusion for financial assistance programs [5].

Copay Assistance Programs

Copay Assistance Programs can also be a valuable resource for individuals struggling with the cost of steroid injections. These programs are designed to assist individuals with insurance coverage but who are still unable to afford their medication due to high copays or deductibles.

For instance, Intravenous Immunoglobulin Replacement Therapy (IVIG) for MS relapses is given by IV infusion. Individuals with insurance should verify coverage, and uninsured individuals should inquire with the facility providing the infusion about financial-assistance programs [5].

Similarly, for procedures like Plasmapheresis (Plasma Exchange) for MS relapses, which is used when steroid treatment is ineffective, individuals are advised to check with their insurance provider to confirm coverage. Uninsured individuals should inquire with the facility providing the procedure about financial-assistance programs.

Overall, these assistance programs can be a crucial resource for individuals needing steroid injections, helping to alleviate some of the financial burden associated with these treatments.

Injection Types and Costs

Understanding the types of steroid injections and their associated costs can be an important part of budgeting for treatment. The prices can vary widely, depending on the type of injection, the setting in which it's administered, and any additional services required.

Varied Costs

Steroid injections can come in many forms, each with its own cost implications. For example, cortisone shots generally range from around $100 to $300, but in certain cases, the price can exceed $1,000 Healthline.

Injection Type	Cost Range
Cortisone Shots	$100 - $300
Facet Joint Injections	$1,000 - $1,600
Epidural Steroid Injections	$100 - $300
Deep Acne Injections	$25 - $100

Prices courtesy Sesame Care and Pain Treatment Specialists

Hospital vs. Outpatient

Where the injection is administered can also influence the cost. For instance, Medicare reports that patients pay an average of $84 for injections when performed at a non-hospital facility, with the average price at a hospital being $146 Healthline.

Injection Location	Average Cost
Non-hospital facility	$84
Hospital	$146

Additional Costs

It's also important to consider the additional costs involved in steroid injections. These may include the office visit, medical imaging (like X-rays or CT scans), and the procedure itself Sesame Care.

For those with insurance coverage, the cost of a cortisone shot can range from $20 to $50 out of pocket, depending on the number of shots needed and whether the shot is deemed medically necessary by the insurance provider Sesame Care.

The cost of steroid injections can be a significant factor when planning for treatment. It's crucial to discuss specific costs with your healthcare provider and understand what your insurance covers before undergoing the procedure.

Effectiveness of Steroid Injections

While understanding the cost of steroid injections is crucial, it is also important to evaluate their effectiveness. Here, we will discuss the efficacy of steroid injections in treating two common conditions: Lumbosacral Radicular Pain and Carpal Tunnel Syndrome.

Lumbosacral Radicular Pain

Lumbosacral radicular pain is a condition that can severely limit mobility and quality of life. Steroid injections, particularly epidural corticosteroid injections (ESIs), have been used as a treatment option. However, there is limited evidence to support the use of ESIs in people with this condition as the treatment effects are small and may not be considered clinically important by patients and clinicians [6].

A Comparative Systematic Review and Meta-Analysis showed that ESIs for radiculopathy or spinal stenosis with sodium chloride solution or bupivacaine were ineffective. In contrast, lidocaine alone or in combination with steroids was significantly effective. The study suggested that using lidocaine alone or in conjunction with steroids can significantly reduce pain and improve function in patients with lumbosacral radicular pain.

Further discussions among subject matter experts revealed that ESIs provided at least 50% pain relief in patients with this condition. They also suggested that ESIs could potentially reduce the need for opioids in patients with lumbosacral radicular pain.

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is another condition where steroid injections have been used as a treatment option. A trial was conducted to investigate whether corticosteroid injection is effective in reducing symptoms and improving hand function in mild to moderate CTS over 6 weeks when compared with night splints. The secondary objectives were to determine specified comparative clinical outcomes and cost effectiveness of corticosteroid injection over 6 and 24 months [7].

The trial was a randomised, multicentre, open label, parallel group clinical trial comparing a single injection of Methylprednisolone Acetate into the carpal tunnel versus 6 weeks of night splinting in patients with mild to moderate CTS.

The primary outcome was the overall score of the Boston Carpal Tunnel Questionnaire (BCTQ) at 6 weeks. Secondary outcomes included BCTQ symptom severity and function status subscales, symptom intensity, interrupted sleep, adherence to splinting, perceived benefit and satisfaction with treatment, work absence and reduction in work performance, EQ-5D-5L, referral to surgery and health utilization costs.

The trial results are expected to make an important contribution to the evidence base available to support effective conservative management of CTS in primary care. This trial is the first to directly compare these treatments for CTS in primary care populations or report on clinical effectiveness at more than 6 months, and compare cost effectiveness of the interventions [7].

It is important to note that while steroid injections can be effective in managing certain conditions, their effectiveness can vary depending on the specific condition, the type of steroid used, and the individual patient's response to the treatment. Therefore, it is important to have a thorough discussion with your healthcare provider to understand the potential benefits and risks before deciding on this treatment option.

Clinical Trials

Clinical trials are an essential part of determining the effectiveness and cost-effectiveness of various treatments, including steroid injections. In the context of these trials, corticosteroid injections have been compared to night splints in treating carpal tunnel syndrome (CTS).

Corticosteroid vs. Night Splints

A study conducted by NCBI investigated the comparative effectiveness of corticosteroid injections against the use of night splints in treating mild to moderate CTS. The study was randomized, multicenter, and featured an open-label, parallel group trial design. Patients in the study either received a single injection of Methylprednisolone Acetate (as 20 mg of Depo-Medrone 40 mg/ml) into the carpal tunnel or 6 weeks of night splinting.

Trial Objectives

The primary objective of the trial was to investigate whether a corticosteroid injection is effective in reducing symptoms and improving hand function in mild to moderate CTS over a 6-week period when compared with night splints. Secondary objectives included determining specified comparative clinical outcomes and the cost effectiveness of corticosteroid injections over 6 and 24 months.

Trial Outcomes

The main outcome of the trial was the overall score of the Boston Carpal Tunnel Questionnaire (BCTQ) at 6 weeks. Secondary outcomes included BCTQ symptom severity and function status subscales, symptom intensity, interrupted sleep, adherence to splinting, perceived benefit and satisfaction with treatment, work absence and reduction in work performance, EQ-5D-5L, referral to surgery, and health utilization costs.

According to the NCBI, the trial is expected to make a significant contribution to the evidence base supporting effective conservative management of CTS in primary care. Previous trials haven't directly compared these treatments for CTS in primary care populations or reported on clinical effectiveness at more than 6 months nor compared cost effectiveness of the interventions.

The trial is registered under ClinicalTrials.gov and ISRCTN, with registration numbers NCT02038452 and ISRCTN09392969 respectively.

This trial provides valuable insights into the question of 'how much do steroid injections cost' by comparing the cost-effectiveness and clinical effectiveness of corticosteroid injections and night splints in treating CTS over periods of 6 and 24 months. These insights can help healthcare providers and patients make more informed decisions about their treatment options.