CPT 97535
The standard charge for Self Care - Home Management Training - 15 Minutes is $244.00. 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
$244.00Insurance Discount
-$15.62Price Negotiated by Insurer
$228.38Deductible 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
$195.62Basic Metabolic Panel
$242.42Ceftriaxone JW Waste Charge per 250 mg
$7.49Enoxaparin JW Waste Charge per 10 mg
$18.72High - Blood Glucose Hi/Lo
$72.07IM/Subsq Injection - 96372
$208.73Legal Blood Draw
$42.12Magnesium, Urine
$35.57Normal saline solution infus J7030
$4.68OTA Therapeutic Activities Charge
$208.73PT TH Gait Training Chg
$247.10Surgicel 1 x 2" [Med]"
$371.59Yes - OT TH Evaluation Low Complexity Chg
$310.75Yes - PT TH Evaluation Low Complexity Chg
$310.75This 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
$244.00Insurance Discount
-$25.77Price Negotiated by Insurer
$218.23Deductible 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
$186.93Basic Metabolic Panel
$231.65Ceftriaxone JW Waste Charge per 250 mg
$7.16Enoxaparin JW Waste Charge per 10 mg
$17.89High - Blood Glucose Hi/Lo
$68.87IM/Subsq Injection - 96372
$199.45Legal Blood Draw
$40.25Magnesium, Urine
$33.99Normal saline solution infus J7030
$4.47OTA Therapeutic Activities Charge
$199.45PT TH Gait Training Chg
$236.12Surgicel 1 x 2" [Med]"
$355.08Yes - OT TH Evaluation Low Complexity Chg
$296.94Yes - PT TH Evaluation Low Complexity Chg
$296.94This 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
$244.00Insurance Discount
-$172.95Price Negotiated by Insurer
$71.05Deductible 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
$8.08Basic Metabolic Panel
$8.80Ceftriaxone JW Waste Charge per 250 mg
$2.33Enoxaparin JW Waste Charge per 10 mg
$5.82High - Blood Glucose Hi/Lo
$5.24IM/Subsq Injection - 96372
$75.77Legal Blood Draw
$9.71Magnesium, Urine
$6.97Normal saline solution infus J7030
$1.46OTA Therapeutic Activities Charge
$64.94PT TH Gait Training Chg
$76.88Surgicel 1 x 2" [Med]"
$115.61Yes - OT TH Evaluation Low Complexity Chg
$96.68Yes - PT TH Evaluation Low Complexity Chg
$96.68This 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
$244.00Price Negotiated by Insurer
$362.96Deductible 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
$30.30Basic Metabolic Panel
$32.99Ceftriaxone JW Waste Charge per 250 mg
$5.41Enoxaparin JW Waste Charge per 10 mg
$13.52High - Blood Glucose Hi/Lo
$19.66IM/Subsq Injection - 96372
$150.75Legal Blood Draw
$30.42Magnesium, Urine
$26.13Normal saline solution infus J7030
$3.38OTA Therapeutic Activities Charge
$362.96PT TH Gait Training Chg
$362.96Surgicel 1 x 2" [Med]"
$268.37Yes - OT TH Evaluation Low Complexity Chg
$362.96Yes - PT TH Evaluation Low Complexity Chg
$362.96This 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
$244.00Price Negotiated by Insurer
$298.48Deductible 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
$14.14Basic Metabolic Panel
$15.40Ceftriaxone JW Waste Charge per 250 mg
$4.16Enoxaparin JW Waste Charge per 10 mg
$10.40High - Blood Glucose Hi/Lo
$9.17IM/Subsq Injection - 96372
$115.96Legal Blood Draw
$23.40Magnesium, Urine
$12.19Normal saline solution infus J7030
$2.60OTA Therapeutic Activities Charge
$298.48PT TH Gait Training Chg
$298.48Surgicel 1 x 2" [Med]"
$206.44Yes - OT TH Evaluation Low Complexity Chg
$298.48Yes - PT TH Evaluation Low Complexity Chg
$298.48This 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
$244.00Price Negotiated by Insurer
$282.88Deductible 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
$13.41Basic Metabolic Panel
$14.61Ceftriaxone JW Waste Charge per 250 mg
$3.99Enoxaparin JW Waste Charge per 10 mg
$9.98High - Blood Glucose Hi/Lo
$8.70IM/Subsq Injection - 96372
$111.32Legal Blood Draw
$22.46Magnesium, Urine
$11.57Normal saline solution infus J7030
$2.50OTA Therapeutic Activities Charge
$282.88PT TH Gait Training Chg
$282.88Surgicel 1 x 2" [Med]"
$198.18Yes - OT TH Evaluation Low Complexity Chg
$282.88Yes - PT TH Evaluation Low Complexity Chg
$282.88This 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
$244.00Insurance Discount
-$109.51Price Negotiated by Insurer
$134.49Deductible 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
$115.20Basic Metabolic Panel
$142.76Ceftriaxone JW Waste Charge per 250 mg
$4.41Enoxaparin JW Waste Charge per 10 mg
$11.02High - Blood Glucose Hi/Lo
$42.44IM/Subsq Injection - 96372
$122.92Legal Blood Draw
$24.80Magnesium, Urine
$20.95Normal saline solution infus J7030
$2.76OTA Therapeutic Activities Charge
$122.92PT TH Gait Training Chg
$145.52Surgicel 1 x 2" [Med]"
$218.83Yes - OT TH Evaluation Low Complexity Chg
$183.00Yes - PT TH Evaluation Low Complexity Chg
$183.00This 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
$244.00Insurance Discount
-$170.80Price Negotiated by Insurer
$73.20Deductible 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
$62.70Basic Metabolic Panel
$77.70Ceftriaxone JW Waste Charge per 250 mg
$2.40Enoxaparin JW Waste Charge per 10 mg
$6.00High - Blood Glucose Hi/Lo
$23.10IM/Subsq Injection - 96372
$66.90Legal Blood Draw
$13.50Magnesium, Urine
$11.40Normal saline solution infus J7030
$1.50OTA Therapeutic Activities Charge
$66.90PT TH Gait Training Chg
$79.20Surgicel 1 x 2" [Med]"
$119.10Yes - OT TH Evaluation Low Complexity Chg
$99.60Yes - PT TH Evaluation Low Complexity Chg
$99.60This 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
$244.00Insurance Discount
-$10.54Price Negotiated by Insurer
$233.46Deductible 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
$199.97Basic Metabolic Panel
$247.81Ceftriaxone JW Waste Charge per 250 mg
$7.65Enoxaparin JW Waste Charge per 10 mg
$19.14High - Blood Glucose Hi/Lo
$73.67IM/Subsq Injection - 96372
$213.37Legal Blood Draw
$43.06Magnesium, Urine
$36.36Normal saline solution infus J7030
$4.78OTA Therapeutic Activities Charge
$213.37PT TH Gait Training Chg
$252.60Surgicel 1 x 2" [Med]"
$379.85Yes - OT TH Evaluation Low Complexity Chg
$317.66Yes - PT TH Evaluation Low Complexity Chg
$317.66This 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
$244.00Insurance Discount
-$101.99Price Negotiated by Insurer
$142.01Deductible 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
$121.64Basic Metabolic Panel
$150.74Ceftriaxone JW Waste Charge per 250 mg
$0.62Enoxaparin JW Waste Charge per 10 mg
$0.85High - Blood Glucose Hi/Lo
$44.81IM/Subsq Injection - 96372
$129.79Magnesium, Urine
$22.12Normal saline solution infus J7030
$3.59OTA Therapeutic Activities Charge
$129.79PT TH Gait Training Chg
$153.65Surgicel 1 x 2" [Med]"
$231.05Yes - OT TH Evaluation Low Complexity Chg
$193.22Yes - PT TH Evaluation Low Complexity Chg
$193.22This 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
$244.00Insurance Discount
-$18.15Price Negotiated by Insurer
$225.85Deductible 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
$193.45Basic Metabolic Panel
$239.73Ceftriaxone JW Waste Charge per 250 mg
$7.40Enoxaparin JW Waste Charge per 10 mg
$18.51High - Blood Glucose Hi/Lo
$71.27IM/Subsq Injection - 96372
$206.41Legal Blood Draw
$41.65Magnesium, Urine
$35.17Normal saline solution infus J7030
$4.63OTA Therapeutic Activities Charge
$206.41PT TH Gait Training Chg
$244.36Surgicel 1 x 2" [Med]"
$367.46Yes - OT TH Evaluation Low Complexity Chg
$307.30Yes - PT TH Evaluation Low Complexity Chg
$307.30This 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
$244.00Insurance Discount
-$10.54Price Negotiated by Insurer
$233.46Deductible 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
$199.97Basic Metabolic Panel
$247.81Ceftriaxone JW Waste Charge per 250 mg
$7.65Enoxaparin JW Waste Charge per 10 mg
$19.14High - Blood Glucose Hi/Lo
$73.67IM/Subsq Injection - 96372
$213.37Legal Blood Draw
$43.06Magnesium, Urine
$36.36Normal saline solution infus J7030
$4.78OTA Therapeutic Activities Charge
$213.37PT TH Gait Training Chg
$252.60Surgicel 1 x 2" [Med]"
$379.85Yes - OT TH Evaluation Low Complexity Chg
$317.66Yes - PT TH Evaluation Low Complexity Chg
$317.66This 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
$244.00Insurance Discount
-$33.92Price Negotiated by Insurer
$210.08Deductible 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
$30.06Basic Metabolic Panel
$32.73Ceftriaxone JW Waste Charge per 250 mg
$6.24Enoxaparin JW Waste Charge per 10 mg
$15.60High - Blood Glucose Hi/Lo
$19.50IM/Subsq Injection - 96372
$281.88Legal Blood Draw
$36.13Magnesium, Urine
$25.92Normal saline solution infus J7030
$3.90OTA Therapeutic Activities Charge
$210.08PT TH Gait Training Chg
$210.08Surgicel 1 x 2" [Med]"
$309.66Yes - OT TH Evaluation Low Complexity Chg
$210.08Yes - PT TH Evaluation Low Complexity Chg
$210.08This 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
$244.00Insurance Discount
-$40.99Price Negotiated by Insurer
$203.01Deductible 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
$173.89Basic Metabolic Panel
$215.49Ceftriaxone JW Waste Charge per 250 mg
$6.66Enoxaparin JW Waste Charge per 10 mg
$16.64High - Blood Glucose Hi/Lo
$64.06IM/Subsq Injection - 96372
$185.54Legal Blood Draw
$37.44Magnesium, Urine
$31.62Normal saline solution infus J7030
$4.16OTA Therapeutic Activities Charge
$185.54PT TH Gait Training Chg
$219.65Surgicel 1 x 2" [Med]"
$330.30Yes - OT TH Evaluation Low Complexity Chg
$276.22Yes - PT TH Evaluation Low Complexity Chg
$276.22This 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
$244.00Insurance Discount
-$91.74Price Negotiated by Insurer
$152.26Deductible 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
$12.12Basic Metabolic Panel
$13.20Ceftriaxone JW Waste Charge per 250 mg
$4.99Enoxaparin JW Waste Charge per 10 mg
$12.48High - Blood Glucose Hi/Lo
$7.86IM/Subsq Injection - 96372
$113.66Legal Blood Draw
$14.57Magnesium, Urine
$10.45Normal saline solution infus J7030
$3.12OTA Therapeutic Activities Charge
$139.15PT TH Gait Training Chg
$164.74Surgicel 1 x 2" [Med]"
$247.73Yes - OT TH Evaluation Low Complexity Chg
$207.17Yes - PT TH Evaluation Low Complexity Chg
$207.17This 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
$244.00Insurance Discount
-$10.54Price Negotiated by Insurer
$233.46Deductible 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
$199.97Basic Metabolic Panel
$247.81Ceftriaxone JW Waste Charge per 250 mg
$7.65Enoxaparin JW Waste Charge per 10 mg
$19.14High - Blood Glucose Hi/Lo
$73.67IM/Subsq Injection - 96372
$213.37Legal Blood Draw
$43.06Magnesium, Urine
$36.36Normal saline solution infus J7030
$4.78OTA Therapeutic Activities Charge
$213.37PT TH Gait Training Chg
$252.60Surgicel 1 x 2" [Med]"
$379.85Yes - OT TH Evaluation Low Complexity Chg
$317.66Yes - PT TH Evaluation Low Complexity Chg
$317.66This 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
$244.00Insurance Discount
-$119.66Price Negotiated by Insurer
$124.34Deductible 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
$106.51Basic Metabolic Panel
$131.99Ceftriaxone JW Waste Charge per 250 mg
$4.08Enoxaparin JW Waste Charge per 10 mg
$10.19High - Blood Glucose Hi/Lo
$39.24IM/Subsq Injection - 96372
$113.64Legal Blood Draw
$22.93Magnesium, Urine
$19.36Normal saline solution infus J7030
$2.55OTA Therapeutic Activities Charge
$113.64PT TH Gait Training Chg
$134.53Surgicel 1 x 2" [Med]"
$202.31Yes - OT TH Evaluation Low Complexity Chg
$169.19Yes - PT TH Evaluation Low Complexity Chg
$169.19This 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
$244.00Insurance Discount
-$79.06Price Negotiated by Insurer
$164.94Deductible 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
$141.28Basic Metabolic Panel
$175.08Ceftriaxone JW Waste Charge per 250 mg
$5.41Enoxaparin JW Waste Charge per 10 mg
$13.52High - Blood Glucose Hi/Lo
$52.05IM/Subsq Injection - 96372
$150.75Legal Blood Draw
$30.42Magnesium, Urine
$25.69Normal saline solution infus J7030
$3.38OTA Therapeutic Activities Charge
$150.75PT TH Gait Training Chg
$178.46Surgicel 1 x 2" [Med]"
$268.37Yes - OT TH Evaluation Low Complexity Chg
$224.43Yes - PT TH Evaluation Low Complexity Chg
$224.43This 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
$244.00Insurance Discount
-$91.74Price Negotiated by Insurer
$152.26Deductible 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
$8.08Basic Metabolic Panel
$8.80Ceftriaxone JW Waste Charge per 250 mg
$4.99Enoxaparin JW Waste Charge per 10 mg
$12.48High - Blood Glucose Hi/Lo
$5.24IM/Subsq Injection - 96372
$75.77Legal Blood Draw
$9.71Magnesium, Urine
$6.97Normal saline solution infus J7030
$3.12OTA Therapeutic Activities Charge
$139.15PT TH Gait Training Chg
$164.74Surgicel 1 x 2" [Med]"
$247.73Yes - OT TH Evaluation Low Complexity Chg
$207.17Yes - PT TH Evaluation Low Complexity Chg
$207.17This 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
$244.00Insurance Discount
-$113.17Price Negotiated by Insurer
$130.83Deductible 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
$32.32Basic Metabolic Panel
$35.19Ceftriaxone JW Waste Charge per 250 mg
$4.16Enoxaparin JW Waste Charge per 10 mg
$10.40High - Blood Glucose Hi/Lo
$20.97IM/Subsq Injection - 96372
$303.10Legal Blood Draw
$38.85Magnesium, Urine
$27.87Normal saline solution infus J7030
$8.28OTA Therapeutic Activities Charge
$115.96PT TH Gait Training Chg
$137.28Surgicel 1 x 2" [Med]"
$206.44Yes - OT TH Evaluation Low Complexity Chg
$172.64Yes - PT TH Evaluation Low Complexity Chg
$172.64This 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
$244.00Insurance Discount
-$53.68Price Negotiated by Insurer
$190.32Deductible 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
$163.02Basic Metabolic Panel
$202.02High - Blood Glucose Hi/Lo
$60.06IM/Subsq Injection - 96372
$173.94Legal Blood Draw
$35.10Magnesium, Urine
$29.64OTA Therapeutic Activities Charge
$173.94PT TH Gait Training Chg
$205.92Yes - OT TH Evaluation Low Complexity Chg
$258.96Yes - PT TH Evaluation Low Complexity Chg
$258.96This 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
$244.00Insurance Discount
-$104.43Price Negotiated by Insurer
$139.57Deductible 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
$119.55Basic Metabolic Panel
$148.15Ceftriaxone JW Waste Charge per 250 mg
$4.58Enoxaparin JW Waste Charge per 10 mg
$11.44High - Blood Glucose Hi/Lo
$44.04IM/Subsq Injection - 96372
$127.56Legal Blood Draw
$25.74Magnesium, Urine
$21.74Normal saline solution infus J7030
$2.86OTA Therapeutic Activities Charge
$127.56PT TH Gait Training Chg
$151.01Surgicel 1 x 2" [Med]"
$227.08Yes - OT TH Evaluation Low Complexity Chg
$189.90Yes - PT TH Evaluation Low Complexity Chg
$189.90This 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
$244.00Insurance Discount
-$56.05Price Negotiated by Insurer
$187.95Deductible 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
$160.99Basic Metabolic Panel
$199.51Ceftriaxone JW Waste Charge per 250 mg
$1.18Enoxaparin JW Waste Charge per 10 mg
$1.61High - Blood Glucose Hi/Lo
$59.31IM/Subsq Injection - 96372
$171.78Legal Blood Draw
$34.66Magnesium, Urine
$29.27Normal saline solution infus J7030
$3.85OTA Therapeutic Activities Charge
$171.78PT TH Gait Training Chg
$203.36Surgicel 1 x 2" [Med]"
$305.81Yes - OT TH Evaluation Low Complexity Chg
$255.74Yes - PT TH Evaluation Low Complexity Chg
$255.74This 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.