CPT 96366
The standard charge for Intravenous infusion, for therapy, prophylaxis, or diagnosis- additional infusions is $264.00. However, the price you pay depends on the rate negotiated by your insurance plan and what portion your insurance plan requires you to contribute towards that amount. Enter your info below to start your estimate.
To calculate an estimate of your cost, you will need two things:
LOCATION
1969 West Hart Road, Beloit, WI, 53511CONTACT
(608) 364-5011 Visit WebsiteBeloit Memorial Hospital is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.
In compliance with federal law, Beloit Memorial Hospital provides a list of standard charges. These are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient’s unique needs.
I understand that the list of standard charges includes only hospital services and does not contain professional fees for non-Beloit Memorial Hospital physicians or advanced practice providers. It does not contain professional fees for anesthesia, physicians or advanced practice providers.
I understand that a single line item charge may not represent a complete medical service. In general, multiple charge line items are necessary to represent all components of a service (e.g. procedures, supplies, and drugs).
I understand that the list of standard charges is not intended for media use.
I understand prices are the list price of all hospital charges and not necessarily what my insurance company will pay or what I will owe to the hospital. My actual bill may include one or more of list price charges.
The hospital typically accepts a rate that is less than the list charges. Your insurer will determine what you will owe after they have paid their agreed upon amount.
We know that the billing and payment processes may seem overwhelming at times. Please contact our team at 608-364-5011.
Choose a plan to view the insurance rate estimate.
Total estimated charges
$264.00Insurance Discount
-$16.90Price Negotiated by Insurer
$247.10Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$195.62IV Infusion For Therapy 1 HR - 96365
$582.19Legal Blood Draw
$42.12Magnesium, Urine
$35.57Surgicel 1 x 2" [Med]"
$371.59This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$27.88Price Negotiated by Insurer
$236.12Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$186.93IV Infusion For Therapy 1 HR - 96365
$556.32Legal Blood Draw
$40.25Magnesium, Urine
$33.99Surgicel 1 x 2" [Med]"
$355.08This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$214.72Price Negotiated by Insurer
$49.28Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$8.08IV Infusion For Therapy 1 HR - 96365
$223.85Legal Blood Draw
$9.71Magnesium, Urine
$6.97Surgicel 1 x 2" [Med]"
$115.61This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$85.54Price Negotiated by Insurer
$178.46Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$30.30IV Infusion For Therapy 1 HR - 96365
$420.47Legal Blood Draw
$30.42Magnesium, Urine
$26.13Surgicel 1 x 2" [Med]"
$268.37This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$126.72Price Negotiated by Insurer
$137.28Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$14.14IV Infusion For Therapy 1 HR - 96365
$323.44Legal Blood Draw
$23.40Magnesium, Urine
$12.19Surgicel 1 x 2" [Med]"
$206.44This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$132.21Price Negotiated by Insurer
$131.79Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$13.41IV Infusion For Therapy 1 HR - 96365
$310.50Legal Blood Draw
$22.46Magnesium, Urine
$11.57Surgicel 1 x 2" [Med]"
$198.18This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$214.72Price Negotiated by Insurer
$49.28Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$8.08IV Infusion For Therapy 1 HR - 96365
$223.85Legal Blood Draw
$9.71Magnesium, Urine
$6.97This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$118.48Price Negotiated by Insurer
$145.52Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$115.20IV Infusion For Therapy 1 HR - 96365
$342.85Legal Blood Draw
$24.80Magnesium, Urine
$20.95Surgicel 1 x 2" [Med]"
$218.83This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$214.72Price Negotiated by Insurer
$49.28Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$8.08IV Infusion For Therapy 1 HR - 96365
$223.85Legal Blood Draw
$9.71Magnesium, Urine
$6.97This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$214.72Price Negotiated by Insurer
$49.28Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$8.08IV Infusion For Therapy 1 HR - 96365
$223.85Legal Blood Draw
$9.71Magnesium, Urine
$6.97This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$184.80Price Negotiated by Insurer
$79.20Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$62.70IV Infusion For Therapy 1 HR - 96365
$186.60Legal Blood Draw
$13.50Magnesium, Urine
$11.40Surgicel 1 x 2" [Med]"
$119.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$11.40Price Negotiated by Insurer
$252.60Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$199.97IV Infusion For Therapy 1 HR - 96365
$595.13Legal Blood Draw
$43.06Magnesium, Urine
$36.36Surgicel 1 x 2" [Med]"
$379.85This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$214.72Price Negotiated by Insurer
$49.28Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$8.08IV Infusion For Therapy 1 HR - 96365
$223.85Legal Blood Draw
$9.71Magnesium, Urine
$6.97This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$110.35Price Negotiated by Insurer
$153.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$121.64IV Infusion For Therapy 1 HR - 96365
$362.00Magnesium, Urine
$22.12Surgicel 1 x 2" [Med]"
$231.05This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$214.72Price Negotiated by Insurer
$49.28Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$8.08IV Infusion For Therapy 1 HR - 96365
$223.85Legal Blood Draw
$9.71Magnesium, Urine
$6.97This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$19.64Price Negotiated by Insurer
$244.36Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$193.45IV Infusion For Therapy 1 HR - 96365
$575.72Legal Blood Draw
$41.65Magnesium, Urine
$35.17Surgicel 1 x 2" [Med]"
$367.46This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$11.40Price Negotiated by Insurer
$252.60Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$199.97IV Infusion For Therapy 1 HR - 96365
$595.13Legal Blood Draw
$43.06Magnesium, Urine
$36.36Surgicel 1 x 2" [Med]"
$379.85This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$80.70Price Negotiated by Insurer
$183.30Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$30.06IV Infusion For Therapy 1 HR - 96365
$832.72Legal Blood Draw
$36.13Magnesium, Urine
$25.92Surgicel 1 x 2" [Med]"
$309.66This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$214.72Price Negotiated by Insurer
$49.28Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$8.08IV Infusion For Therapy 1 HR - 96365
$223.85Legal Blood Draw
$9.71Magnesium, Urine
$6.97This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$214.72Price Negotiated by Insurer
$49.28Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$8.08IV Infusion For Therapy 1 HR - 96365
$223.85Legal Blood Draw
$9.71Magnesium, Urine
$6.97This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$214.72Price Negotiated by Insurer
$49.28Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$8.08IV Infusion For Therapy 1 HR - 96365
$223.85Legal Blood Draw
$9.71Magnesium, Urine
$6.97This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$214.72Price Negotiated by Insurer
$49.28Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$8.08IV Infusion For Therapy 1 HR - 96365
$223.85Legal Blood Draw
$9.71Magnesium, Urine
$6.97This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$44.35Price Negotiated by Insurer
$219.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$173.89IV Infusion For Therapy 1 HR - 96365
$517.50Legal Blood Draw
$37.44Magnesium, Urine
$31.62Surgicel 1 x 2" [Med]"
$330.30This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$190.09Price Negotiated by Insurer
$73.91Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$12.12IV Infusion For Therapy 1 HR - 96365
$335.77Legal Blood Draw
$14.57Magnesium, Urine
$10.45Surgicel 1 x 2" [Med]"
$247.73This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$11.40Price Negotiated by Insurer
$252.60Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$199.97IV Infusion For Therapy 1 HR - 96365
$595.13Legal Blood Draw
$43.06Magnesium, Urine
$36.36Surgicel 1 x 2" [Med]"
$379.85This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$129.47Price Negotiated by Insurer
$134.53Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$106.51IV Infusion For Therapy 1 HR - 96365
$316.97Legal Blood Draw
$22.93Magnesium, Urine
$19.36Surgicel 1 x 2" [Med]"
$202.31This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$85.54Price Negotiated by Insurer
$178.46Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$141.28IV Infusion For Therapy 1 HR - 96365
$420.47Legal Blood Draw
$30.42Magnesium, Urine
$25.69Surgicel 1 x 2" [Med]"
$268.37This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$214.72Price Negotiated by Insurer
$49.28Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$8.08IV Infusion For Therapy 1 HR - 96365
$223.85Legal Blood Draw
$9.71Magnesium, Urine
$6.97Surgicel 1 x 2" [Med]"
$247.73This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$66.90Price Negotiated by Insurer
$197.10Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$32.32IV Infusion For Therapy 1 HR - 96365
$895.40Legal Blood Draw
$38.85Magnesium, Urine
$27.87Surgicel 1 x 2" [Med]"
$206.44This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$214.72Price Negotiated by Insurer
$49.28Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$8.08IV Infusion For Therapy 1 HR - 96365
$223.85Legal Blood Draw
$9.71Magnesium, Urine
$6.97This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$58.08Price Negotiated by Insurer
$205.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$163.02IV Infusion For Therapy 1 HR - 96365
$485.16Legal Blood Draw
$35.10Magnesium, Urine
$29.64This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$112.99Price Negotiated by Insurer
$151.01Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$119.55IV Infusion For Therapy 1 HR - 96365
$355.78Legal Blood Draw
$25.74Magnesium, Urine
$21.74Surgicel 1 x 2" [Med]"
$227.08This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$214.72Price Negotiated by Insurer
$49.28Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$8.08IV Infusion For Therapy 1 HR - 96365
$223.85Legal Blood Draw
$9.71Magnesium, Urine
$6.97This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.
Total estimated charges
$264.00Insurance Discount
-$60.64Price Negotiated by Insurer
$203.36Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.Auto Diff
$160.99IV Infusion For Therapy 1 HR - 96365
$479.13Legal Blood Draw
$34.66Magnesium, Urine
$29.27Surgicel 1 x 2" [Med]"
$305.81This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Beloit Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Beloit Memorial Hospital directly.