raig daniels
$7,235.94
That's what Memorial Sloan Kettering quoted me for a single consultation visit.
One afternoon. Some blood draws. A surgeon across a desk.
I'll get to the number. First, the setup.
I'm currently on FOLFIRI at Champalimaud — one of Europe's better cancer research institutions, as it happens, sitting 25 km from my house. My care here is solid. But the surgery I'm working toward — cytoreductive surgery, possibly with HIPEC — is highly specialized, and I want multiple expert opinions before anyone opens me up.
MSK is on the list. It's widely considered the best cancer hospital in the world. So I reached out.
Carmen, a patient services rep, called me back. She was warm, professional and thorough. She confirmed what I'd already suspected: MSK requires new patients to come in person for a surgical consultation of this complexity. They used to offer a remote second-opinion program — international patients could submit their records and receive a written review without flying to New York. That program is paused as of late 2025. There's no workaround. No virtual consult for a new international patient. You want MSK's surgical team to look at your case; you show up at 1275 York Avenue.
Then Carmen sent the Good Faith Estimate.
The Breakdown
The No Surprises Act — US federal law — requires providers to give uninsured patients a written cost estimate before services are rendered. I don't have US insurance. I live in Portugal. So I got the full sticker price.
$7,235.94. Split into two parts.
These are the labs MSK runs as part of their standard new patient intake:
| MSK Hospital Charges | $3,060.94 |
|---|---|
| CBC with automated differential A complete blood count with white cell breakdown. I've had this drawn roughly 30 times since diagnosis. | $167.48 |
| Venipuncture draw charge The fee for collecting the blood. | $123.00 |
| CA-125. An ovarian cancer marker Not standard for colorectal, but apparently part of MSK's peritoneal disease intake panel. | $450.50 |
| Alpha-fetoprotein (AFP) A liver/germ cell marker. Also not colorectal-specific, but in their baseline. | $323.30 |
| CEA. My colorectal tumor marker. I have a longitudinal history going back to diagnosis, with a draw as recently as March 10, 2026. | $430.36 |
| CA 19-9. Another GI cancer marker. Also well-documented in my Portuguese records. | $425.06 |
| Comprehensive Metabolic Panel. Liver, kidneys, electrolytes Tracked through every chemotherapy cycle. | $403.86 |
| Hospital outpatient visit fee (G0463) Facility charge for the visit itself. | $468.52 |
| Surcharge | $268.86 |
| Physician Charges | $4,175.00 |
|---|---|
| Pathology consultation on referred material requiring new slide preparation × 2 An MSK pathologist will cut new sections from the paraffin blocks I send from Portugal and review them independently. They don't take another institution's pathology on faith. Two consultations likely covers my primary colon tumor and the peritoneal recurrence specimen separately. |
$860.00 |
| Unlisted ultrasound procedure × 3 In the context of a peritoneal disease surgical consult, this most likely means a point-of-care abdominal ultrasound as part of staging. |
$1,920.00 |
| Cytopathology, concentration technique Analysis of peritoneal washings to detect free malignant cells in the abdominal cavity. Relevant to surgical candidacy. |
$120.00 |
| New patient office visit, high medical complexity, 60 minutes The actual surgeon consultation. High complexity. Maximum time tier. The conversation I'd be flying to New York for. |
$1,275.00 |
Why I'm Putting This Number in Public
I'm posting it because most people — including most Americans — have no framework for what US healthcare actually costs. What they see day-to-day is the negotiated rate, filtered through insurance. The co-pay. The deductible. The "surprise bill" that's already been discounted from something much larger.This is what it costs without the filter.
One visit. One surgeon. Some blood draws and a second look at my slides.
$7,235.94
I've been receiving chemotherapy at Champalimaud for over a year, with private health insurance. My total out-of-pocket cost for one year looks nothing like this number.I'm not yet sure I'll make the trip. There are other centers I'm evaluating — surgical programs with comparable outcomes and more accessible consultation logistics for someone flying from Lisbon on an active chemo schedule. The number isn't disqualifying on its own. But it's part of the calculation, and it deserves to be seen clearly.