CPT 74174
The standard charge for CTA scan of abdomen is $7,922.00. 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
$7,922.00Insurance Discount
-$507.01Price Negotiated by Insurer
$7,414.99Deductible 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
$195.62CT Angiography Chest, Abd + Iliofemoral
$6,914.23EKG Acquisition
$344.45Legal Blood Draw
$42.12OMNIPAQUE 180 10ml VIAL [MED]
$152.57Troponin T/34483
$71.14This 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
$7,922.00Insurance Discount
-$836.56Price Negotiated by Insurer
$7,085.44Deductible 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
$186.93CT Angiography Chest, Abd + Iliofemoral
$6,606.93EKG Acquisition
$329.14Legal Blood Draw
$40.25OMNIPAQUE 180 10ml VIAL [MED]
$145.79Troponin T/34483
$67.97This 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
$7,922.00Insurance Discount
-$7,554.85Price Negotiated by Insurer
$367.15Deductible 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
$8.08CT Angiography Chest, Abd + Iliofemoral
$2,151.09EKG Acquisition
$62.09Legal Blood Draw
$9.71OMNIPAQUE 180 10ml VIAL [MED]
$47.47Troponin T/34483
$12.97This 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
$7,922.00Insurance Discount
-$2,566.73Price Negotiated by Insurer
$5,355.27Deductible 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
$30.30CT Angiography Chest, Abd + Iliofemoral
$3,333.20EKG Acquisition
$248.77Legal Blood Draw
$30.42OMNIPAQUE 180 10ml VIAL [MED]
$110.19Troponin T/34483
$48.63This 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
$7,922.00Insurance Discount
-$3,802.56Price Negotiated by Insurer
$4,119.44Deductible 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
$14.14CT Angiography Chest, Abd + Iliofemoral
$2,689.44EKG Acquisition
$191.36Legal Blood Draw
$23.40OMNIPAQUE 180 10ml VIAL [MED]
$84.76Troponin T/34483
$22.70This 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
$7,922.00Insurance Discount
-$3,967.34Price Negotiated by Insurer
$3,954.66Deductible 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
$13.41CT Angiography Chest, Abd + Iliofemoral
$2,552.16EKG Acquisition
$183.71Legal Blood Draw
$22.46OMNIPAQUE 180 10ml VIAL [MED]
$81.37Troponin T/34483
$21.53This 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
$7,922.00Insurance Discount
-$7,554.85Price Negotiated by Insurer
$367.15Deductible 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
$8.08EKG Acquisition
$62.09Legal Blood Draw
$9.71Troponin T/34483
$12.97This 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
$7,922.00Insurance Discount
-$3,555.39Price Negotiated by Insurer
$4,366.61Deductible 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
$115.20CT Angiography Chest, Abd + Iliofemoral
$4,071.71EKG Acquisition
$202.84Legal Blood Draw
$24.80OMNIPAQUE 180 10ml VIAL [MED]
$89.85Troponin T/34483
$41.89This 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
$7,922.00Insurance Discount
-$7,554.85Price Negotiated by Insurer
$367.15Deductible 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
$8.08EKG Acquisition
$62.09Legal Blood Draw
$9.71Troponin T/34483
$12.97This 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
$7,922.00Insurance Discount
-$7,554.85Price Negotiated by Insurer
$367.15Deductible 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
$8.08EKG Acquisition
$62.09Legal Blood Draw
$9.71Troponin T/34483
$12.97This 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
$7,922.00Insurance Discount
-$5,545.40Price Negotiated by Insurer
$2,376.60Deductible 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
$62.70CT Angiography Chest, Abd + Iliofemoral
$2,216.10EKG Acquisition
$110.40Legal Blood Draw
$13.50OMNIPAQUE 180 10ml VIAL [MED]
$48.90Troponin T/34483
$22.80This 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
$7,922.00Insurance Discount
-$342.23Price Negotiated by Insurer
$7,579.77Deductible 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
$199.97CT Angiography Chest, Abd + Iliofemoral
$7,067.88EKG Acquisition
$352.10Legal Blood Draw
$43.06OMNIPAQUE 180 10ml VIAL [MED]
$155.96Troponin T/34483
$72.72This 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
$7,922.00Insurance Discount
-$7,554.85Price Negotiated by Insurer
$367.15Deductible 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
$8.08EKG Acquisition
$62.09Legal Blood Draw
$9.71Troponin T/34483
$12.97This 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
$7,922.00Insurance Discount
-$3,311.40Price Negotiated by Insurer
$4,610.60Deductible 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
$121.64CT Angiography Chest, Abd + Iliofemoral
$4,299.23EKG Acquisition
$214.18OMNIPAQUE 180 10ml VIAL [MED]
$0.19Troponin T/34483
$44.23This 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
$7,922.00Insurance Discount
-$7,554.85Price Negotiated by Insurer
$367.15Deductible 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
$8.08EKG Acquisition
$62.09Legal Blood Draw
$9.71Troponin T/34483
$12.97This 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
$7,922.00Insurance Discount
-$589.40Price Negotiated by Insurer
$7,332.60Deductible 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
$193.45CT Angiography Chest, Abd + Iliofemoral
$6,837.41EKG Acquisition
$340.62Legal Blood Draw
$41.65OMNIPAQUE 180 10ml VIAL [MED]
$150.87Troponin T/34483
$70.35This 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
$7,922.00Insurance Discount
-$342.23Price Negotiated by Insurer
$7,579.77Deductible 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
$199.97CT Angiography Chest, Abd + Iliofemoral
$7,067.88EKG Acquisition
$352.10Legal Blood Draw
$43.06OMNIPAQUE 180 10ml VIAL [MED]
$155.96Troponin T/34483
$72.72This 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
$7,922.00Insurance Discount
-$6,556.20Price Negotiated by Insurer
$1,365.80Deductible 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
$30.06CT Angiography Chest, Abd + Iliofemoral
$5,761.86EKG Acquisition
$230.97Legal Blood Draw
$36.13OMNIPAQUE 180 10ml VIAL [MED]
$127.14Troponin T/34483
$48.24This 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
$7,922.00Insurance Discount
-$7,554.85Price Negotiated by Insurer
$367.15Deductible 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
$8.08EKG Acquisition
$62.09Legal Blood Draw
$9.71Troponin T/34483
$12.97This 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
$7,922.00Insurance Discount
-$7,554.85Price Negotiated by Insurer
$367.15Deductible 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
$8.08EKG Acquisition
$62.09Legal Blood Draw
$9.71Troponin T/34483
$12.97This 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
$7,922.00Insurance Discount
-$7,554.85Price Negotiated by Insurer
$367.15Deductible 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
$8.08EKG Acquisition
$62.09Legal Blood Draw
$9.71Troponin T/34483
$12.97This 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
$7,922.00Insurance Discount
-$7,554.85Price Negotiated by Insurer
$367.15Deductible 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
$8.08EKG Acquisition
$62.09Legal Blood Draw
$9.71Troponin T/34483
$12.97This 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
$7,922.00Insurance Discount
-$1,330.90Price Negotiated by Insurer
$6,591.10Deductible 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
$173.89CT Angiography Chest, Abd + Iliofemoral
$6,145.98EKG Acquisition
$306.18Legal Blood Draw
$37.44OMNIPAQUE 180 10ml VIAL [MED]
$135.62Troponin T/34483
$63.23This 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
$7,922.00Insurance Discount
-$7,371.27Price Negotiated by Insurer
$550.73Deductible 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
$12.12CT Angiography Chest, Abd + Iliofemoral
$4,609.49EKG Acquisition
$93.13Legal Blood Draw
$14.57OMNIPAQUE 180 10ml VIAL [MED]
$101.71Troponin T/34483
$19.45This 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
$7,922.00Insurance Discount
-$342.23Price Negotiated by Insurer
$7,579.77Deductible 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
$199.97CT Angiography Chest, Abd + Iliofemoral
$7,067.88EKG Acquisition
$352.10Legal Blood Draw
$43.06OMNIPAQUE 180 10ml VIAL [MED]
$155.96Troponin T/34483
$72.72This 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
$7,922.00Insurance Discount
-$3,884.95Price Negotiated by Insurer
$4,037.05Deductible 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
$106.51CT Angiography Chest, Abd + Iliofemoral
$3,764.42EKG Acquisition
$187.53Legal Blood Draw
$22.93OMNIPAQUE 180 10ml VIAL [MED]
$83.06Troponin T/34483
$38.73This 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
$7,922.00Insurance Discount
-$2,566.73Price Negotiated by Insurer
$5,355.27Deductible 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
$141.28CT Angiography Chest, Abd + Iliofemoral
$4,993.61EKG Acquisition
$248.77Legal Blood Draw
$30.42OMNIPAQUE 180 10ml VIAL [MED]
$110.19Troponin T/34483
$51.38This 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
$7,922.00Insurance Discount
-$7,554.85Price Negotiated by Insurer
$367.15Deductible 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
$8.08CT Angiography Chest, Abd + Iliofemoral
$4,609.49EKG Acquisition
$62.09Legal Blood Draw
$9.71OMNIPAQUE 180 10ml VIAL [MED]
$101.71Troponin T/34483
$12.97This 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
$7,922.00Insurance Discount
-$6,453.40Price Negotiated by Insurer
$1,468.60Deductible 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
$32.32CT Angiography Chest, Abd + Iliofemoral
$782.66EKG Acquisition
$248.35Legal Blood Draw
$38.85OMNIPAQUE 180 10ml VIAL [MED]
$0.62Troponin T/34483
$51.88This 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
$7,922.00Insurance Discount
-$7,554.85Price Negotiated by Insurer
$367.15Deductible 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
$8.08EKG Acquisition
$62.09Legal Blood Draw
$9.71Troponin T/34483
$12.97This 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
$7,922.00Insurance Discount
-$3,390.62Price Negotiated by Insurer
$4,531.38Deductible 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
$119.55CT Angiography Chest, Abd + Iliofemoral
$4,225.36EKG Acquisition
$210.50Legal Blood Draw
$25.74OMNIPAQUE 180 10ml VIAL [MED]
$93.24Troponin T/34483
$43.47This 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
$7,922.00Insurance Discount
-$7,554.85Price Negotiated by Insurer
$367.15Deductible 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
$8.08EKG Acquisition
$62.09Legal Blood Draw
$9.71Troponin T/34483
$12.97This 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
$7,922.00Insurance Discount
-$1,819.68Price Negotiated by Insurer
$6,102.32Deductible 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
$160.99CT Angiography Chest, Abd + Iliofemoral
$1,369.66EKG Acquisition
$283.47Legal Blood Draw
$34.66OMNIPAQUE 180 10ml VIAL [MED]
$0.36Troponin T/34483
$58.54This 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.