Acupuncture and Herb Prices in the USA

CC wrote:
 
I have made an appointment with a local acupuncturist and am hopeful... and also very curious and interested, as this is will be my first experience with this sort of medicine. Is there any sort of advice you would give me as I go into this -- anything I should be aware of or knowledgeable about? Because I am not very knowledgeable in this field, I wouldn't want to be talked into paying for things that I don't need, so that is one concern.

Okay, that's a good question. How much does this cost, what are the hidden charges, etc...

Let's begin with the basic acupuncture treatment.

Treatments run from $25 at a teaching clinic of an acupuncture school to $250 for an MD who can bill insurance companies. Among acupuncturists I would say that a price of $50 to $150 per treatment is about right. Are the more expensive treatments of higher quality? Nope, not at all. I always encourage people to decide how comfortable they feel with their practitioner and allow that to be their barometer as to the doctor's efficacy. That and the actual efficacy of the treatments, of course. Higher price acupuncturists could be very busy so they can raise their prices, but that may be more the quality of their marketing than their medical abilities. They may be fresh out of school and attempting to look important so they raise their prices, they may be in a high rent area and so they simply must charge more. There are many things that can effect the price of a treatment. One is the quality of the doctor, the others have no effect on their ability to help you. Again, I encourage people to seek out the practitioner with whom they feel comfortable.

Added Prices:

First treatment: Add nothing at a teaching clinic, but expect the first treatment to take up to two hours. Students are slow as a rule. Don't hurry them, they don't want to make mistakes. This is a good thing.

For licensed practitioners, there is sometimes an additional charge of anywhere from $20 to $50 for that first treatment. It does tend to take longer. The reason for this is that we like to ask a lot of questions, look at your tongue, take your pulse, watch your spirit and so on. These are all diagnostic tools. After the first treatment we repeat many of these things, but it won't take as long and so we only charge more for that first treatment in which all of these questions and so on are being asked for the first time.

For more on what takes place during your first treatment, please see the article describing the first treatment found at: http://Acupuncture.com/Diagnosis/firsttreat.htm.

Moxibustion: There may be a $10 or $20 dollar charge for this. Probably the added charge will only occur if there is insurance billing going on. Moxibustion is the application of heat to the acupuncture points. It does require someone to sit or stand there and do it. That means it costs someone money to pay for that person. I don't personally charge extra for moxa at this time, but if practitioners do, I think that's okay.

Electro-stimulation: This is the application of a micro-current of electricity to acupuncture needles. A 9-Volt battery is used to generate this electricity. It is used for aches and pains with a specific nerve issue. MD's who graduate from the Joseph Helms course like to use e-stim more than the practitioners of traditional Chinese medicine, so perhaps you'll see more e-stim being used with an MD rather than an L.Ac. There are numerous differences between the MD's doing "medical acupuncture" and those doing traditional Chinese medicine, but I don't want to get off on my rant right now so I'll leave it at that. Again, we tend to bill insurance companies for e-stim more often than we bill patients, but if there is an added charge, it should be in the $20 range.

Cupping: These are vacuum cups applied to the site of aches or pains. Sometimes we use cupping to remove pathogens too, such as a cold virus from the lungs. This is another service that is often times provided for free for the patient and perhaps an added $20 may show up on an insurance invoice.

Massage: Some acupuncturists will just add this activity to the usual acupuncture treatment, especially if the treatment is for some muscle or soft tissue pain that will respond quickly to massage. However, for the full body massages that we've all come to love, expect to pay about $1 per minute. Again, things are less expensive at massage or acupuncture schools.

Herbal Medicines

Herbs come in many forms. Here are some of the more popular:

Raw herbs are roots and branches, rocks and seeds, flowers and seal penis. You heard me. Anyway, these herbs are given to the patient to take home and cook, then consume. The price varies somewhat based on what the ingredients are. The usual and customary price for an herb formula (a package with your prescription in it that will contain anywhere from four to forty individual herbs) runs about $5 per day's worth in an herbal pharmacy in a Chinatown. It tends to be a bit more if your acupuncturist has his or her own herb pharmacy. If there are some precious or otherwise expensive ingredients in your prescription, expect that price to rise as high as $10 per day. Anything more than that, be sure that your doctor is really good and worth it.

Patent Formulas are herbal products that are manufactured in China or Asia and imported into the West. These too vary widely in price, but the most frequently seen patent formulas are those that look like little black b-b's. These bottles are found in Chinatowns being sold for around $2 per bottle. Practitioners sell them for up to $6 per bottle of 200 pills. Some practitioners will prevent the patient from purchasing these pills outside of their clinic by taking the pills out of the bottle and putting them into a plastic bag or otherwise prevent the patient from knowing what's in the bottle. This prevents the patient from knowing what it is that they're taking and prevents them from purchasing them elsewhere.

I'm all for paying a little extra to pay the practitioner for the time and hassle of going to Chinatown to pick up these herbs and stock them in their office, but hiding the true identity and thus the price from the patient is I think a little over the line. But that's just my line. We all have lines and no two are the same.

Powdered extracts can be sold in the straight powdered form or put into capsules. A month's worth of powdered extract will run you between $60 and $120 depending on the practitioner's mark-up and the cost of the ingredients. If the powder is delivered in capsules, add about $20 to the cost. Powdered extracts are basically the herb tea with the water removed. This is different than herbs that are simply ground up and placed into capsules. I would think that the ground up herbs would be cheaper, but I don't have any experience with that particular delivery system, so I can't anticipate the price on that.

High practitioner mark-ups shouldn't be viewed as any ethical problem. I myself mark-up my herbs simply because of the cost of my education to be able to prescribe or write the appropriate formula. There is a world of difference between what someone with a masters degree in Oriental medicine does and what the stock boy at your local GNC does. When you pay for marked-up the herbs, you're paying for that competence.

Powdered extracts can come in pre-made capsuled formulations as well. These tend to run anywhere from $25 to $35 per bottle of 100 capsules. At the highest dosage, this will last you about a week. Your practitioner can better anticipate the appropriate dosage for you. This herbal delivery system is among the most popular in the USA and perhaps the West in general. One reason for this is that we can put our own labels on classical formulas. You'll find many of these types of products in health food stores. Tinctures (liquids) also fall into this category. They tend to be around the same price.

Teas sealed in bags: There is one other herbal delivery system that comes up from time to time. This system is more popular in the Korean community of Southern California, I'm not sure if it is used outside of this community. Once the herbal formula is written, the herbs are cooked in a special machine that takes the herb tea and places it into sealed packages that are opened every time its time for your tea. Presumably it can be heated up in a microwave, or on a wood stove depending on the technology available to you. I am not sure of the prices for this product, but I would be skeptical of anything over $10 per day's worth of herbs. Again, if there are expensive herbs in the decoction it will be more. Which herbs are expensive? That's not something I can cover with any real authority in this article.

The prices I've listed here are not the end-all regulatory reality of the marketplace. I just based what I wrote on my personal experience on the Westside of Los Angeles, California. If you're being asked to pay more than the prices listed above, there may be an excellent reason for it, but if you're being asked to pay much more than what is listed above you may chose to seek out another practitioner and get a second opinion.

Acupuncturists are not known for their scams, but we all must remain at least a little bit vigilant to avoid being taken advantage in the name of alternative health.

Be well.

	Al Stone, L.Ac. Beyond Well Being Acupuncture and Chinese Herbal Medicines Santa Monica, CA. (310) 264-6668