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Cost range for ESWT

Posted by KevinH on 2/16/05 at 13:52 (169172)

My insurance will not cover ESWT and I would like to find out a cost estimate of the procedure. My present doctor will not discuss the procedure with me, he insists on more cortisone injections. I have had 5 injections in the past 2 months and they haven't worked. I have some broken out skin in the heel area where the needle was inserted.. it is numb in the area but still have heel pain. I would like to get an estimate of the procedure before scheduling an appt with a new physician. I rather see first if I can afford it before going to a new physician.

Re: Cost range for ESWT

Sharon B. on 2/16/05 at 14:59 (169175)

We paid almost $3000 for both feet for the Ossatron procedure, and had to pre-pay all of it since insurance didn't cover it. That could vary I'm sure depending on your doctor's fee. We may get a little back from the anesthesiologist.

A couple of my husband's doctors (out of the 6 we saw) weren't too fond of the cortizone shots, especially if the first one didn't work, because they do have a risk involved of doing more damage.

Re: Cost range for ESWT

Dr. Z on 2/16/05 at 15:01 (169176)

Additional local steriod injections can and do cause tissue damage. No more for you is my opinion. Cost will vary depending upon if you have it done in an office or in an ASC. Where do you live?

Re: Cost range for ESWT

Rob M on 2/16/05 at 15:09 (169177)

In Canada 3 treatments are $1050 per body part. see http://www.painfree-eswt.com . Price is one thing, but experience of the person delivering the treatment is very important.

Rob Mitchell
PainFree ESWT

Re: Cost range for ESWT

vince on 2/16/05 at 16:55 (169178)

Avoid any and all cortisone injections. They very often do not help and almost always can cause damage to the foot structure. It is over used and probably often used improperly. For PF do any of the rest of the conservative things like orthotics, rest, PT, boots, cast, night splints BUT NO CORTISONE unless you want to destroy the fat pad underneath your heel and spend the rest of your life walking on bone.

Re: Cost range for ESWT

Dr. Z on 2/16/05 at 17:19 (169182)

What are you basing your statement that you should avoid ALL steriod injections. No cortisone is just plain wrong.

Re: Cost range for ESWT

Sharon B. on 2/16/05 at 18:30 (169191)

I should also add that we used an orthopedic surgeon. The best in the region actually, so we know it cost a bit more, but he's the most recommended and we trusted him the most. After seeing 3 podiatrists, we liked nothing they had to offer. I'm sure there are great ones out there, but orthopedic surgeons also perform the surgery.

My husband did try one shot per foot, but since it didn't do any good, we didn't pursue it further. It can help in some cases so I've heard, but not in my husband's case.

Re: Cost range for ESWT

Dr. Z on 2/16/05 at 18:41 (169192)


It really shouldn't cost any more whether a podiatrist performs the ESWT procedure or an orthopedic doctor. It is very important that you use a physician that you trust and have confidence with, and this is something that I see you did. Many people think that ESWT is soooo simple and you should go for the cheapest etc. As you do appreciate, the diagnosis for Plantar fascitis is so important as well as when to use ESWT. Price comparison should be done but just going for the cheap doc instead of who you think is right for the job well there is the old story you get what you pay for.
ESWT takes skill and experience . The nerve block if not done correctly can cause serious, permenant pain. I guess you either get it or don't You sound like someone who gets it

Re: Cost range for ESWT

vince on 2/16/05 at 19:26 (169195)

Personal experience, convesations with people who have had cortisone, discussions with a couple of podiatrists, the experience of posters here who have had many shots that were not effective. Podiatrist like it because insurance pays for it and they make BIG $'s on the treatment. I have been told by 2 podiatrists that they try one costisone shot and that's all that should be used. If the results were real good they may do it again a year later if the symptoms re-occur. Dr. Z-How many patients have you seen who's fat pad in their heels have been destroyed by cortisone shots?

Re: Cost range for ESWT

Dr. Z on 2/16/05 at 19:33 (169198)

'Podiatrist like it because there is big money it'. You are paid about the same as an oil change in your Car. The blanket statement that you should never have a local steriod injection is wrong. It should be given with caution and when it is indicated but never is just not the case.

Re: Cost range for ESWT

Connie H. on 2/17/05 at 06:44 (169240)

Hi KevinH, I just had ESWT in December. My first Pod. really would have been happy to continue giving me cortizone shots, but he did mention ESWT as an alternative. However, he used the ossatron machine, which would have been 10K out of pocket, and my insurance refused to pay for it. I searched United Shockwave's website to find a doctor near me who could treat me with the Dornier machine. I met her, and liked her immensely. I was treated in her office, with her standing by pretty much the entire time. My insurance company DID pay after all, with out of pocket expense being $800 for both feet. I am MUCH improved and so very grateful I found this website. It gave me hope for relief that I haven't had for years. If there is no podiatrist in your area, I'd recommend flying up to Dr. Z's and getting it treatment there. Don't put it off. I wish I'd done something years ago.

Re: Cost range for ESWT

Tina H on 2/17/05 at 11:45 (169258)

Kevin- My insurance did not cover ESWT and my doctor gave it to me for 'her cost' of $500. Visits before and after were not included, my insurance did cover those except for the copay. I'v seen several people post here in the last 6 months siting doctors who charge considerably less than the thousands of dollars many people are paying. I remember one poster was charged only $300 (that's really low) and several citing fees in the $500 to $800 range. You might be able to find these posts by searching. Good luck. Tina

Re: Cost range for ESWT

Ed Davis, DPM on 2/18/05 at 00:15 (169293)

Your comments may be based on your locale but very few insurers cover ESWT in Washjington State.

Re: Cost range for ESWT

Ed Davis, DPM on 2/18/05 at 00:17 (169294)

There is much more money in surgical treatment. A doctor affirming the advantages of ESWT over surgery is willing to place the patient first and accept substantially less reimbursement.

Re: Cost range for ESWT

KevinH on 2/22/05 at 09:40 (169621)

Thanks everyone for your posts of information, I appreciate it!
I live in Knoxville, TN. I will check around for some clinics that perform the ESWT, sounds like alot of people have had results from it. If I have to work overtime and pay cash for it, it may be worth it in the long run.
Thanks again,

Re: Cost range for ESWT

PodinFla on 3/02/05 at 22:47 (170336)

Quote: Avoid any and all cortisone injections.

I'm not sure I agree with your statement. Yes, too much cortisone is a bad thing. However, in a patient who has been unresponsive to traditional conservative therapy, the heel spur cocktail will typically help in an acute or chronic pain setting. You do have to be wary of those individuals who will recommend more than 3 injections in a year. I can honestly say that I've never had one patient who has ruptured their plantar fascia after recieving a plantar fascial injection. I have had a college basketball player rupture her plantar fascia after a jumpshot though. What you may or may not understand is that to adequately treat plantar fasciitis, it requires a combo approach. You have to individualize stretching, taping, orthosis, REST, and injection therapy for each patient. I do use injection therapy. Most patients get better with stretching and shoewear modification. I got better with stretching and wearing a running shoe up until bedtime. As far as surgery goes, I don't recommend it usually. If the patient can't afford ESWT then as a last resort we will recommend surgery. That's usually at least 8-10 months after their initial presentation. At most, I perform 3 or 4 open plantar fasciotomies per year. I do not recommend EPF's for personal reasons. I know many who perform this procedure and get good results so to speak. I did three open procedures last year. Two were successful and one is better but not completely better. In my area of the country (florida) I've performed approximately 30 ESWT's (Ossatron) and have had two true failures. Both in extremely overweight women who were teachers. One of them completely disregarded the post op instructions and began taking feldene approximately two days after the treatment. Anyway, I get off topic a wee bit. I will say that repeated injections is not healthy. An occasional injection will help with the pain and inflammatory process.