$15 or $800: How Much Does Botox Cost?

How much does a Botox treatment cost? Is it $15 or $800, which are both prices that we found in a price survey of the New York area?

The answer: both are right.

You probably have one of two reactions:

1. Why should I care?
2. How can both be true?

The price survey is part of an effort to seek transparency in the health care marketplace: In other words, you should know what stuff costs.

If you’re not interested in Botox, then the price may not seem important to you.

But stick with us for a second: It IS important as a test case and as an example of vagaries of the health care marketplace.

We’ve found it’s pretty easy to get an answer to the question of what Botox and other discretionary or cosmetic procedures costs — as opposed to things like an MRI or a colonoscopy.

This is because the discretionary procedures tend to be out of pocket, and providers are used to answering the question: how much does it cost? An MRI, on the other hand, might have several prices: A sticker price, a negotiated or reimbursed rate (what the insurance company pays), the rate that Medicare and Medicaid pay for treatments for people who are older and those who have low income, an out-of-network price, and so on. We know about this because we’ve done pricing surveys for about 35 common procedures in seven U.S. metro areas, collecting cash or self-pay prices for both medically necessary procedures (an MRI, a colonoscopy) and discretionary procedures (Botox, Lasik).

Breaking Down the Cost of Botox

OK, so back to the question. Does Botox cost $15 or $800?

First, the basics. Botox is a brand name for the Botulinum toxin Type A, which is used to relax facial muscles, thus reducing lines and wrinkles in cosmetic uses. It can also be used to ease migraines, excessive sweating and a few other conditions.

When Botox is injected, it is priced two different ways:

1. By the vial or unit ($12 per unit, $15 per vial)
2. By the area, such as the area between the eyes, where frown lines are often treated with Botox ($450 — $800 for an area)

The decision to use a given number of units or vials, or to treat an entire area, depends on the discretion of the provider. Some places have a required minimum purchase (minimum 50 units, for example) so the two pricing practices are hard to compare.

The average price nationwide for a Botox treatment is $328, according to the American Society for Aesthetic Plastic Surgery. That’s for Botox and Dysport, both brand names for Botulinum Toxin type A. (There are other injectable cosmetic surgery treatments, too – we didn’t price those.)

The website realself.com is another resource where cosmetic surgery patients contribute their information about their procedures. Botox patients claim prices of $1 to $11,111; we are inclined to believe the $400 to $800 range in the New York area is the most common.

Finding Out the Cost of Any Procedure

If you’re trying to plan a procedure – Botox, an MRI or anything else — asking the price in advance often results in some equivocation: “it depends on the patient,” or “$15 per vial, and we won’t know how many until we examine you.”

Other things to know about Botox treatments: Some providers charge a consultation fee, which is waived if you choose to proceed with the injections but charged if you decline. Also, who is doing the injection? Make sure it’s a trained, certified professional. As in many other things, training and credentials are important. In some practices, a junior employee may perform the procedure for a lesser rate. Make sure that’s what you want.

Not a Botox patient? Listen anyway. This is good practice for asking the price for other medical procedures like an MRI or a colonoscopy, where the information can be much harder to get. The common replies you could get: “What’s your insurance?” “We can’t tell you because it depends on your deductible.” “We don’t know.” “You’ll have to call billing.”

Your best response: “Is there a consultation fee” or “Are any other fees necessary?” or “Is that the total charge?” Because in a funny way, an MRI isn’t so different from Botox: You should be able to know what things cost. (The state of Massachusetts, by the way, has passed a law saying that you should be able to know these things.)

Here’s a list of cash or self-pay prices for an MRI in Texas: From $325 to $2,432.  And with the most expensive one, a “reading fee,” we were told, was not included.

Image: iStock