
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
-$24.40Price Negotiated by Insurer
$219.60Deductible 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.
Additional IV Push Same Drug - 96376
$179.10Additional Push of Medication - 96375
$210.60.Auto Diff
$188.10Basic Metabolic Panel
$233.10Bone Marrow Peripheral Blood, TC
$40.50Comprehensive Metabolic Panel
$303.30Enoxaparin JW Waste Charge per 10 mg
$18.00Eylea 8mg - Eylea Med Charge
$4,774.50Hemogram
$135.90High - Blood Glucose Hi/Lo
$69.30IM/Subsq Injection - 96372
$200.70Insulin Injection J1815
$5.40IV Infusion for Hydration Add HR - 96361
$248.40Legal Blood Draw
$40.50Magnesium, Urine
$34.20Normal saline solution infus J7030
$4.50OTA Therapeutic Activities Charge
$200.70Surgicel 1 x 2" [Med]"
$357.30Yes - OT TH Evaluation Low Complexity Chg
$298.80Yes - PT TH Evaluation Low Complexity Chg
$298.80This 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
$244.00Insurance Discount
-$34.16Price Negotiated by Insurer
$209.84Deductible 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.
Additional IV Push Same Drug - 96376
$171.14Additional Push of Medication - 96375
$201.24.Auto Diff
$179.74Basic Metabolic Panel
$222.74Bone Marrow Peripheral Blood, TC
$38.70Comprehensive Metabolic Panel
$289.82Enoxaparin JW Waste Charge per 10 mg
$17.20Eylea 8mg - Eylea Med Charge
$4,562.30Hemogram
$129.86High - Blood Glucose Hi/Lo
$66.22IM/Subsq Injection - 96372
$191.78Insulin Injection J1815
$5.16IV Infusion for Hydration Add HR - 96361
$237.36Legal Blood Draw
$38.70Magnesium, Urine
$32.68Normal saline solution infus J7030
$4.30OTA Therapeutic Activities Charge
$191.78Surgicel 1 x 2" [Med]"
$341.42Yes - OT TH Evaluation Low Complexity Chg
$285.52Yes - PT TH Evaluation Low Complexity Chg
$285.52This 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
-$175.68Price Negotiated by Insurer
$68.32Deductible 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.
Additional IV Push Same Drug - 96376
$55.72Additional Push of Medication - 96375
$46.95.Auto Diff
$7.77Basic Metabolic Panel
$8.46Bone Marrow Peripheral Blood, TC
$3.80Comprehensive Metabolic Panel
$10.56Enoxaparin JW Waste Charge per 10 mg
$5.60Eylea 8mg - Eylea Med Charge
$1,485.40Hemogram
$6.47High - Blood Glucose Hi/Lo
$5.04IM/Subsq Injection - 96372
$69.63Insulin Injection J1815
$1.68IV Infusion for Hydration Add HR - 96361
$46.95Legal Blood Draw
$8.57Magnesium, Urine
$6.70Normal saline solution infus J7030
$1.40OTA Therapeutic Activities Charge
$62.44Surgicel 1 x 2" [Med]"
$111.16Yes - OT TH Evaluation Low Complexity Chg
$92.96Yes - PT TH Evaluation Low Complexity Chg
$92.96This 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
$349.00Deductible 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.
Additional IV Push Same Drug - 96376
$129.35Additional Push of Medication - 96375
$152.10.Auto Diff
$29.14Basic Metabolic Panel
$31.72Bone Marrow Peripheral Blood, TC
$14.25Comprehensive Metabolic Panel
$39.60Enoxaparin JW Waste Charge per 10 mg
$13.00Eylea 8mg - Eylea Med Charge
$3,448.25Hemogram
$24.26High - Blood Glucose Hi/Lo
$18.90IM/Subsq Injection - 96372
$144.95Insulin Injection J1815
$3.90IV Infusion for Hydration Add HR - 96361
$179.40Legal Blood Draw
$29.25Magnesium, Urine
$25.12Normal saline solution infus J7030
$3.25OTA Therapeutic Activities Charge
$349.00Surgicel 1 x 2" [Med]"
$258.05Yes - OT TH Evaluation Low Complexity Chg
$349.00Yes - PT TH Evaluation Low Complexity Chg
$349.00This 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
$244.00Price Negotiated by Insurer
$287.00Deductible 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.
Additional IV Push Same Drug - 96376
$99.50Additional Push of Medication - 96375
$117.00.Auto Diff
$13.60Basic Metabolic Panel
$14.80Bone Marrow Peripheral Blood, TC
$6.65Comprehensive Metabolic Panel
$18.48Enoxaparin JW Waste Charge per 10 mg
$10.00Eylea 8mg - Eylea Med Charge
$2,652.50Hemogram
$11.32High - Blood Glucose Hi/Lo
$8.82IM/Subsq Injection - 96372
$111.50Insulin Injection J1815
$3.00IV Infusion for Hydration Add HR - 96361
$138.00Legal Blood Draw
$22.50Magnesium, Urine
$11.72Normal saline solution infus J7030
$2.50OTA Therapeutic Activities Charge
$287.00Surgicel 1 x 2" [Med]"
$198.50Yes - OT TH Evaluation Low Complexity Chg
$287.00Yes - PT TH Evaluation Low Complexity Chg
$287.00This 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
$244.00Price Negotiated by Insurer
$272.00Deductible 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.
Additional IV Push Same Drug - 96376
$95.52Additional Push of Medication - 96375
$112.32.Auto Diff
$12.90Basic Metabolic Panel
$14.04Bone Marrow Peripheral Blood, TC
$6.31Comprehensive Metabolic Panel
$17.53Enoxaparin JW Waste Charge per 10 mg
$9.60Eylea 8mg - Eylea Med Charge
$2,546.40Hemogram
$10.74High - Blood Glucose Hi/Lo
$8.37IM/Subsq Injection - 96372
$107.04Insulin Injection J1815
$2.88IV Infusion for Hydration Add HR - 96361
$132.48Legal Blood Draw
$21.60Magnesium, Urine
$11.12Normal saline solution infus J7030
$2.40OTA Therapeutic Activities Charge
$272.00Surgicel 1 x 2" [Med]"
$190.56Yes - OT TH Evaluation Low Complexity Chg
$272.00Yes - PT TH Evaluation Low Complexity Chg
$272.00This 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
-$114.68Price Negotiated by Insurer
$129.32Deductible 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.
Additional IV Push Same Drug - 96376
$105.47Additional Push of Medication - 96375
$124.02.Auto Diff
$110.77Basic Metabolic Panel
$137.27Bone Marrow Peripheral Blood, TC
$23.85Comprehensive Metabolic Panel
$178.61Enoxaparin JW Waste Charge per 10 mg
$10.60Eylea 8mg - Eylea Med Charge
$2,811.65Hemogram
$80.03High - Blood Glucose Hi/Lo
$40.81IM/Subsq Injection - 96372
$118.19Insulin Injection J1815
$3.18IV Infusion for Hydration Add HR - 96361
$146.28Legal Blood Draw
$23.85Magnesium, Urine
$20.14Normal saline solution infus J7030
$2.65OTA Therapeutic Activities Charge
$118.19Surgicel 1 x 2" [Med]"
$210.41Yes - OT TH Evaluation Low Complexity Chg
$175.96Yes - PT TH Evaluation Low Complexity Chg
$175.96This 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
-$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.
Additional IV Push Same Drug - 96376
$59.70Additional Push of Medication - 96375
$70.20.Auto Diff
$62.70Basic Metabolic Panel
$77.70Bone Marrow Peripheral Blood, TC
$13.50Comprehensive Metabolic Panel
$101.10Enoxaparin JW Waste Charge per 10 mg
$6.00Eylea 8mg - Eylea Med Charge
$1,591.50Hemogram
$45.30High - Blood Glucose Hi/Lo
$23.10IM/Subsq Injection - 96372
$66.90Insulin Injection J1815
$1.80IV Infusion for Hydration Add HR - 96361
$82.80Legal Blood Draw
$13.50Magnesium, Urine
$11.40Normal saline solution infus J7030
$1.50OTA Therapeutic Activities Charge
$66.90Surgicel 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
-$19.52Price Negotiated by Insurer
$224.48Deductible 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.
Additional IV Push Same Drug - 96376
$183.08Additional Push of Medication - 96375
$215.28.Auto Diff
$192.28Basic Metabolic Panel
$238.28Bone Marrow Peripheral Blood, TC
$41.40Comprehensive Metabolic Panel
$310.04Enoxaparin JW Waste Charge per 10 mg
$18.40Eylea 8mg - Eylea Med Charge
$4,880.60Hemogram
$138.92High - Blood Glucose Hi/Lo
$70.84IM/Subsq Injection - 96372
$205.16Insulin Injection J1815
$5.52IV Infusion for Hydration Add HR - 96361
$253.92Legal Blood Draw
$41.40Magnesium, Urine
$34.96Normal saline solution infus J7030
$4.60OTA Therapeutic Activities Charge
$205.16Surgicel 1 x 2" [Med]"
$365.24Yes - OT TH Evaluation Low Complexity Chg
$305.44Yes - PT TH Evaluation Low Complexity Chg
$305.44This 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
$244.00Insurance Discount
-$107.46Price Negotiated by Insurer
$136.54Deductible 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.
Additional IV Push Same Drug - 96376
$111.36Additional Push of Medication - 96375
$130.95.Auto Diff
$116.96Basic Metabolic Panel
$144.94Bone Marrow Peripheral Blood, TC
$25.18Comprehensive Metabolic Panel
$188.59Enoxaparin JW Waste Charge per 10 mg
$11.19Eylea 8mg - Eylea Med Charge
$2,968.68Hemogram
$84.50High - Blood Glucose Hi/Lo
$43.09IM/Subsq Injection - 96372
$124.79Insulin Injection J1815
$3.36IV Infusion for Hydration Add HR - 96361
$154.45Magnesium, Urine
$21.26Normal saline solution infus J7030
$3.45OTA Therapeutic Activities Charge
$124.79Surgicel 1 x 2" [Med]"
$222.16Yes - OT TH Evaluation Low Complexity Chg
$185.79Yes - PT TH Evaluation Low Complexity Chg
$185.79This 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
-$26.84Price Negotiated by Insurer
$217.16Deductible 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.
Additional IV Push Same Drug - 96376
$177.11Additional Push of Medication - 96375
$208.26.Auto Diff
$186.01Basic Metabolic Panel
$230.51Bone Marrow Peripheral Blood, TC
$40.05Comprehensive Metabolic Panel
$299.93Enoxaparin JW Waste Charge per 10 mg
$17.80Eylea 8mg - Eylea Med Charge
$4,721.45Hemogram
$134.39High - Blood Glucose Hi/Lo
$68.53IM/Subsq Injection - 96372
$198.47Insulin Injection J1815
$5.34IV Infusion for Hydration Add HR - 96361
$245.64Legal Blood Draw
$40.05Magnesium, Urine
$33.82Normal saline solution infus J7030
$4.45OTA Therapeutic Activities Charge
$198.47Surgicel 1 x 2" [Med]"
$353.33Yes - OT TH Evaluation Low Complexity Chg
$295.48Yes - PT TH Evaluation Low Complexity Chg
$295.48This 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
$244.00Insurance Discount
-$19.52Price Negotiated by Insurer
$224.48Deductible 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.
Additional IV Push Same Drug - 96376
$183.08Additional Push of Medication - 96375
$215.28.Auto Diff
$192.28Basic Metabolic Panel
$238.28Bone Marrow Peripheral Blood, TC
$41.40Comprehensive Metabolic Panel
$310.04Enoxaparin JW Waste Charge per 10 mg
$18.40Eylea 8mg - Eylea Med Charge
$4,880.60Hemogram
$138.92High - Blood Glucose Hi/Lo
$70.84IM/Subsq Injection - 96372
$205.16Insulin Injection J1815
$5.52IV Infusion for Hydration Add HR - 96361
$253.92Legal Blood Draw
$41.40Magnesium, Urine
$34.96Normal saline solution infus J7030
$4.60OTA Therapeutic Activities Charge
$205.16Surgicel 1 x 2" [Med]"
$365.24Yes - OT TH Evaluation Low Complexity Chg
$305.44Yes - PT TH Evaluation Low Complexity Chg
$305.44This 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
$244.00Insurance Discount
-$42.00Price Negotiated by Insurer
$202.00Deductible 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.
Additional IV Push Same Drug - 96376
$149.25Additional Push of Medication - 96375
$174.65.Auto Diff
$28.90Basic Metabolic Panel
$31.47Bone Marrow Peripheral Blood, TC
$14.14Comprehensive Metabolic Panel
$39.28Enoxaparin JW Waste Charge per 10 mg
$15.00Eylea 8mg - Eylea Med Charge
$3,978.75Hemogram
$24.07High - Blood Glucose Hi/Lo
$18.75IM/Subsq Injection - 96372
$259.02Insulin Injection J1815
$4.50IV Infusion for Hydration Add HR - 96361
$174.65Legal Blood Draw
$31.88Magnesium, Urine
$24.92Normal saline solution infus J7030
$3.75OTA Therapeutic Activities Charge
$202.00Surgicel 1 x 2" [Med]"
$297.75Yes - OT TH Evaluation Low Complexity Chg
$202.00Yes - PT TH Evaluation Low Complexity Chg
$202.00This 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
-$48.80Price Negotiated by Insurer
$195.20Deductible 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.
Additional IV Push Same Drug - 96376
$159.20Additional Push of Medication - 96375
$187.20.Auto Diff
$167.20Basic Metabolic Panel
$207.20Bone Marrow Peripheral Blood, TC
$36.00Comprehensive Metabolic Panel
$269.60Enoxaparin JW Waste Charge per 10 mg
$16.00Eylea 8mg - Eylea Med Charge
$4,244.00Hemogram
$120.80High - Blood Glucose Hi/Lo
$61.60IM/Subsq Injection - 96372
$178.40Insulin Injection J1815
$4.80IV Infusion for Hydration Add HR - 96361
$220.80Legal Blood Draw
$36.00Magnesium, Urine
$30.40Normal saline solution infus J7030
$4.00OTA Therapeutic Activities Charge
$178.40Surgicel 1 x 2" [Med]"
$317.60Yes - OT TH Evaluation Low Complexity Chg
$265.60Yes - PT TH Evaluation Low Complexity Chg
$265.60This 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
-$97.60Price Negotiated by Insurer
$146.40Deductible 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.
Additional IV Push Same Drug - 96376
$119.40Additional Push of Medication - 96375
$70.42.Auto Diff
$11.66Basic Metabolic Panel
$12.69Bone Marrow Peripheral Blood, TC
$5.70Comprehensive Metabolic Panel
$15.84Enoxaparin JW Waste Charge per 10 mg
$12.00Eylea 8mg - Eylea Med Charge
$3,183.00Hemogram
$9.70High - Blood Glucose Hi/Lo
$7.56IM/Subsq Injection - 96372
$104.44Insulin Injection J1815
$3.60IV Infusion for Hydration Add HR - 96361
$70.42Legal Blood Draw
$12.86Magnesium, Urine
$10.05Normal saline solution infus J7030
$3.00OTA Therapeutic Activities Charge
$133.80Surgicel 1 x 2" [Med]"
$238.20Yes - OT TH Evaluation Low Complexity Chg
$199.20Yes - PT TH Evaluation Low Complexity Chg
$199.20This 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
-$19.52Price Negotiated by Insurer
$224.48Deductible 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.
Additional IV Push Same Drug - 96376
$183.08Additional Push of Medication - 96375
$215.28.Auto Diff
$192.28Basic Metabolic Panel
$238.28Bone Marrow Peripheral Blood, TC
$41.40Comprehensive Metabolic Panel
$310.04Enoxaparin JW Waste Charge per 10 mg
$18.40Eylea 8mg - Eylea Med Charge
$4,880.60Hemogram
$138.92High - Blood Glucose Hi/Lo
$70.84IM/Subsq Injection - 96372
$205.16Insulin Injection J1815
$5.52IV Infusion for Hydration Add HR - 96361
$253.92Legal Blood Draw
$41.40Magnesium, Urine
$34.96Normal saline solution infus J7030
$4.60OTA Therapeutic Activities Charge
$205.16Surgicel 1 x 2" [Med]"
$365.24Yes - OT TH Evaluation Low Complexity Chg
$305.44Yes - PT TH Evaluation Low Complexity Chg
$305.44This 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
$244.00Insurance Discount
-$124.44Price Negotiated by Insurer
$119.56Deductible 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.
Additional IV Push Same Drug - 96376
$97.51Additional Push of Medication - 96375
$114.66.Auto Diff
$102.41Basic Metabolic Panel
$126.91Bone Marrow Peripheral Blood, TC
$22.05Comprehensive Metabolic Panel
$165.13Enoxaparin JW Waste Charge per 10 mg
$9.80Eylea 8mg - Eylea Med Charge
$2,599.45Hemogram
$73.99High - Blood Glucose Hi/Lo
$37.73IM/Subsq Injection - 96372
$109.27Insulin Injection J1815
$2.94IV Infusion for Hydration Add HR - 96361
$135.24Legal Blood Draw
$22.05Magnesium, Urine
$18.62Normal saline solution infus J7030
$2.45OTA Therapeutic Activities Charge
$109.27Surgicel 1 x 2" [Med]"
$194.53Yes - OT TH Evaluation Low Complexity Chg
$162.68Yes - PT TH Evaluation Low Complexity Chg
$162.68This 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
$244.00Insurance Discount
-$85.40Price Negotiated by Insurer
$158.60Deductible 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.
Additional IV Push Same Drug - 96376
$129.35Additional Push of Medication - 96375
$152.10.Auto Diff
$135.85Basic Metabolic Panel
$168.35Bone Marrow Peripheral Blood, TC
$29.25Comprehensive Metabolic Panel
$219.05Enoxaparin JW Waste Charge per 10 mg
$13.00Eylea 8mg - Eylea Med Charge
$3,448.25Hemogram
$98.15High - Blood Glucose Hi/Lo
$50.05IM/Subsq Injection - 96372
$144.95Insulin Injection J1815
$3.90IV Infusion for Hydration Add HR - 96361
$179.40Legal Blood Draw
$29.25Magnesium, Urine
$24.70Normal saline solution infus J7030
$3.25OTA Therapeutic Activities Charge
$144.95Surgicel 1 x 2" [Med]"
$258.05Yes - OT TH Evaluation Low Complexity Chg
$215.80Yes - PT TH Evaluation Low Complexity Chg
$215.80This 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
$244.00Insurance Discount
-$97.60Price Negotiated by Insurer
$146.40Deductible 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.
Additional IV Push Same Drug - 96376
$119.40Additional Push of Medication - 96375
$46.95.Auto Diff
$7.77Basic Metabolic Panel
$8.46Bone Marrow Peripheral Blood, TC
$3.80Comprehensive Metabolic Panel
$10.56Enoxaparin JW Waste Charge per 10 mg
$12.00Eylea 8mg - Eylea Med Charge
$3,183.00Hemogram
$6.47High - Blood Glucose Hi/Lo
$5.04IM/Subsq Injection - 96372
$69.63Insulin Injection J1815
$3.60IV Infusion for Hydration Add HR - 96361
$46.95Legal Blood Draw
$8.57Magnesium, Urine
$6.70Normal saline solution infus J7030
$3.00OTA Therapeutic Activities Charge
$133.80Surgicel 1 x 2" [Med]"
$238.20Yes - OT TH Evaluation Low Complexity Chg
$199.20Yes - PT TH Evaluation Low Complexity Chg
$199.20This 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
$976.00Deductible 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.
Additional IV Push Same Drug - 96376
$796.00Additional Push of Medication - 96375
$187.80.Auto Diff
$31.08Basic Metabolic Panel
$33.84Bone Marrow Peripheral Blood, TC
$15.20Comprehensive Metabolic Panel
$42.24Enoxaparin JW Waste Charge per 10 mg
$80.00Eylea 8mg - Eylea Med Charge
$21,220.00Hemogram
$25.88High - Blood Glucose Hi/Lo
$20.16IM/Subsq Injection - 96372
$278.52Insulin Injection J1815
$24.00IV Infusion for Hydration Add HR - 96361
$187.80Legal Blood Draw
$34.28Magnesium, Urine
$26.80Normal saline solution infus J7030
$20.00OTA Therapeutic Activities Charge
$892.00Surgicel 1 x 2" [Med]"
$1,588.00Yes - OT TH Evaluation Low Complexity Chg
$1,328.00Yes - PT TH Evaluation Low Complexity Chg
$1,328.00This 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
-$61.00Price Negotiated by Insurer
$183.00Deductible 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.
Additional IV Push Same Drug - 96376
$149.25Additional Push of Medication - 96375
$175.50.Auto Diff
$156.75Basic Metabolic Panel
$194.25Bone Marrow Peripheral Blood, TC
$33.75Comprehensive Metabolic Panel
$252.75Hemogram
$113.25High - Blood Glucose Hi/Lo
$57.75IM/Subsq Injection - 96372
$167.25IV Infusion for Hydration Add HR - 96361
$207.00Legal Blood Draw
$33.75Magnesium, Urine
$28.50OTA Therapeutic Activities Charge
$167.25Yes - OT TH Evaluation Low Complexity Chg
$249.00Yes - PT TH Evaluation Low Complexity Chg
$249.00This 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
-$109.80Price Negotiated by Insurer
$134.20Deductible 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.
Additional IV Push Same Drug - 96376
$109.45Additional Push of Medication - 96375
$128.70.Auto Diff
$114.95Basic Metabolic Panel
$142.45Bone Marrow Peripheral Blood, TC
$24.75Comprehensive Metabolic Panel
$185.35Enoxaparin JW Waste Charge per 10 mg
$11.00Eylea 8mg - Eylea Med Charge
$2,917.75Hemogram
$83.05High - Blood Glucose Hi/Lo
$42.35IM/Subsq Injection - 96372
$122.65Insulin Injection J1815
$3.30IV Infusion for Hydration Add HR - 96361
$151.80Legal Blood Draw
$24.75Magnesium, Urine
$20.90Normal saline solution infus J7030
$2.75OTA Therapeutic Activities Charge
$122.65Surgicel 1 x 2" [Med]"
$218.35Yes - OT TH Evaluation Low Complexity Chg
$182.60Yes - PT TH Evaluation Low Complexity Chg
$182.60This 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
-$63.27Price Negotiated by Insurer
$180.73Deductible 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.
Additional IV Push Same Drug - 96376
$147.40Additional Push of Medication - 96375
$173.32.Auto Diff
$154.81Basic Metabolic Panel
$191.84Bone Marrow Peripheral Blood, TC
$33.33Comprehensive Metabolic Panel
$249.62Enoxaparin JW Waste Charge per 10 mg
$14.81Eylea 8mg - Eylea Med Charge
$3,929.41Hemogram
$111.85High - Blood Glucose Hi/Lo
$57.03IM/Subsq Injection - 96372
$165.18Insulin Injection J1815
$4.44IV Infusion for Hydration Add HR - 96361
$204.43Legal Blood Draw
$33.33Magnesium, Urine
$28.15Normal saline solution infus J7030
$3.70OTA Therapeutic Activities Charge
$165.18Surgicel 1 x 2" [Med]"
$294.06Yes - OT TH Evaluation Low Complexity Chg
$245.91Yes - PT TH Evaluation Low Complexity Chg
$245.91This 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.