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
$179.10.Auto Diff
$188.10Basic Metabolic Panel
$233.10Bone Marrow Peripheral Blood, TC
$40.50Enoxaparin 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
$200.70IV Infusion for Hydration Add HR - 96361
$248.40Legal Blood Draw
$40.50Magnesium, Urine
$34.20Normal saline solution infus J7030
$4.50OTA Therapeutic Activities Charge
$200.70OT TH Therapeutic Exercise Chg
$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
$171.14.Auto Diff
$179.74Basic Metabolic Panel
$222.74Bone Marrow Peripheral Blood, TC
$38.70Enoxaparin 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
$191.78IV Infusion for Hydration Add HR - 96361
$237.36Legal Blood Draw
$38.70Magnesium, Urine
$32.68Normal saline solution infus J7030
$4.30OTA Therapeutic Activities Charge
$191.78OT TH Therapeutic Exercise Chg
$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
$55.72.Auto Diff
$7.77Basic Metabolic Panel
$8.46Bone Marrow Peripheral Blood, TC
$3.80Enoxaparin 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
$69.63IV Infusion for Hydration Add HR - 96361
$46.95Legal Blood Draw
$8.57Magnesium, Urine
$6.70Normal saline solution infus J7030
$1.40OTA Therapeutic Activities Charge
$62.44OT TH Therapeutic Exercise Chg
$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
$129.35.Auto Diff
$29.14Basic Metabolic Panel
$31.72Bone Marrow Peripheral Blood, TC
$14.25Enoxaparin 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
$144.95IV Infusion for Hydration Add HR - 96361
$179.40Legal Blood Draw
$29.25Magnesium, Urine
$25.12Normal saline solution infus J7030
$3.25OTA Therapeutic Activities Charge
$349.00OT TH Therapeutic Exercise Chg
$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
$99.50.Auto Diff
$13.60Basic Metabolic Panel
$14.80Bone Marrow Peripheral Blood, TC
$6.65Enoxaparin 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
$111.50IV Infusion for Hydration Add HR - 96361
$138.00Legal Blood Draw
$22.50Magnesium, Urine
$11.72Normal saline solution infus J7030
$2.50OTA Therapeutic Activities Charge
$287.00OT TH Therapeutic Exercise Chg
$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
$95.52.Auto Diff
$12.90Basic Metabolic Panel
$14.04Bone Marrow Peripheral Blood, TC
$6.31Enoxaparin 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
$107.04IV Infusion for Hydration Add HR - 96361
$132.48Legal Blood Draw
$21.60Magnesium, Urine
$11.12Normal saline solution infus J7030
$2.40OTA Therapeutic Activities Charge
$272.00OT TH Therapeutic Exercise Chg
$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
$105.47.Auto Diff
$110.77Basic Metabolic Panel
$137.27Bone Marrow Peripheral Blood, TC
$23.85Enoxaparin 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
$118.19IV Infusion for Hydration Add HR - 96361
$146.28Legal Blood Draw
$23.85Magnesium, Urine
$20.14Normal saline solution infus J7030
$2.65OTA Therapeutic Activities Charge
$118.19OT TH Therapeutic Exercise Chg
$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
$59.70.Auto Diff
$62.70Basic Metabolic Panel
$77.70Bone Marrow Peripheral Blood, TC
$13.50Enoxaparin 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
$66.90IV Infusion for Hydration Add HR - 96361
$82.80Legal Blood Draw
$13.50Magnesium, Urine
$11.40Normal saline solution infus J7030
$1.50OTA Therapeutic Activities Charge
$66.90OT TH Therapeutic Exercise Chg
$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
$183.08.Auto Diff
$192.28Basic Metabolic Panel
$238.28Bone Marrow Peripheral Blood, TC
$41.40Enoxaparin 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
$205.16IV Infusion for Hydration Add HR - 96361
$253.92Legal Blood Draw
$41.40Magnesium, Urine
$34.96Normal saline solution infus J7030
$4.60OTA Therapeutic Activities Charge
$205.16OT TH Therapeutic Exercise Chg
$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
$111.36Enoxaparin JW Waste Charge per 10 mg
$11.19Eylea 8mg - Eylea Med Charge
$2,968.68IM/Subsq Injection - 96372
$124.79IV Infusion for Hydration Add HR - 96361
$154.45Normal saline solution infus J7030
$3.45OTA Therapeutic Activities Charge
$124.79OT TH Therapeutic Exercise Chg
$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
$177.11.Auto Diff
$186.01Basic Metabolic Panel
$230.51Bone Marrow Peripheral Blood, TC
$40.05Enoxaparin 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
$198.47IV Infusion for Hydration Add HR - 96361
$245.64Legal Blood Draw
$40.05Magnesium, Urine
$33.82Normal saline solution infus J7030
$4.45OTA Therapeutic Activities Charge
$198.47OT TH Therapeutic Exercise Chg
$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
$183.08.Auto Diff
$192.28Basic Metabolic Panel
$238.28Bone Marrow Peripheral Blood, TC
$41.40Enoxaparin 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
$205.16IV Infusion for Hydration Add HR - 96361
$253.92Legal Blood Draw
$41.40Magnesium, Urine
$34.96Normal saline solution infus J7030
$4.60OTA Therapeutic Activities Charge
$205.16OT TH Therapeutic Exercise Chg
$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
$149.25.Auto Diff
$28.90Basic Metabolic Panel
$31.47Bone Marrow Peripheral Blood, TC
$14.14Enoxaparin 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
$259.02IV Infusion for Hydration Add HR - 96361
$174.65Legal Blood Draw
$31.88Magnesium, Urine
$24.92Normal saline solution infus J7030
$3.75OTA Therapeutic Activities Charge
$202.00OT TH Therapeutic Exercise Chg
$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
$159.20.Auto Diff
$167.20Basic Metabolic Panel
$207.20Bone Marrow Peripheral Blood, TC
$36.00Enoxaparin 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
$178.40IV Infusion for Hydration Add HR - 96361
$220.80Legal Blood Draw
$36.00Magnesium, Urine
$30.40Normal saline solution infus J7030
$4.00OTA Therapeutic Activities Charge
$178.40OT TH Therapeutic Exercise Chg
$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
$119.40.Auto Diff
$11.66Basic Metabolic Panel
$12.69Bone Marrow Peripheral Blood, TC
$5.70Enoxaparin 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
$104.44IV Infusion for Hydration Add HR - 96361
$70.42Legal Blood Draw
$12.86Magnesium, Urine
$10.05Normal saline solution infus J7030
$3.00OTA Therapeutic Activities Charge
$133.80OT TH Therapeutic Exercise Chg
$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
$183.08.Auto Diff
$192.28Basic Metabolic Panel
$238.28Bone Marrow Peripheral Blood, TC
$41.40Enoxaparin 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
$205.16IV Infusion for Hydration Add HR - 96361
$253.92Legal Blood Draw
$41.40Magnesium, Urine
$34.96Normal saline solution infus J7030
$4.60OTA Therapeutic Activities Charge
$205.16OT TH Therapeutic Exercise Chg
$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
$97.51.Auto Diff
$102.41Basic Metabolic Panel
$126.91Bone Marrow Peripheral Blood, TC
$22.05Enoxaparin 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
$109.27IV Infusion for Hydration Add HR - 96361
$135.24Legal Blood Draw
$22.05Magnesium, Urine
$18.62Normal saline solution infus J7030
$2.45OTA Therapeutic Activities Charge
$109.27OT TH Therapeutic Exercise Chg
$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
$129.35.Auto Diff
$135.85Basic Metabolic Panel
$168.35Bone Marrow Peripheral Blood, TC
$29.25Enoxaparin 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
$144.95IV Infusion for Hydration Add HR - 96361
$179.40Legal Blood Draw
$29.25Magnesium, Urine
$24.70Normal saline solution infus J7030
$3.25OTA Therapeutic Activities Charge
$144.95OT TH Therapeutic Exercise Chg
$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
$119.40.Auto Diff
$7.77Basic Metabolic Panel
$8.46Bone Marrow Peripheral Blood, TC
$3.80Enoxaparin 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
$69.63IV Infusion for Hydration Add HR - 96361
$46.95Legal Blood Draw
$8.57Magnesium, Urine
$6.70Normal saline solution infus J7030
$3.00OTA Therapeutic Activities Charge
$133.80OT TH Therapeutic Exercise Chg
$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.
.Auto Diff
$836.00Basic Metabolic Panel
$1,036.00Bone Marrow Peripheral Blood, TC
$180.00Enoxaparin JW Waste Charge per 10 mg
$80.00Eylea 8mg - Eylea Med Charge
$700.24Hemogram
$604.00High - Blood Glucose Hi/Lo
$308.00Legal Blood Draw
$180.00Magnesium, Urine
$152.00Normal saline solution infus J7030
$1,465.68OTA Therapeutic Activities Charge
$892.00OT TH Therapeutic Exercise Chg
$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
$149.25.Auto Diff
$156.75Basic Metabolic Panel
$194.25Bone Marrow Peripheral Blood, TC
$33.75Hemogram
$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
$167.25OT TH Therapeutic Exercise Chg
$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
$109.45.Auto Diff
$114.95Basic Metabolic Panel
$142.45Bone Marrow Peripheral Blood, TC
$24.75Enoxaparin 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
$122.65IV Infusion for Hydration Add HR - 96361
$151.80Legal Blood Draw
$24.75Magnesium, Urine
$20.90Normal saline solution infus J7030
$2.75OTA Therapeutic Activities Charge
$122.65OT TH Therapeutic Exercise Chg
$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
$147.40.Auto Diff
$154.81Basic Metabolic Panel
$191.84Bone Marrow Peripheral Blood, TC
$33.33Enoxaparin 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
$165.18IV Infusion for Hydration Add HR - 96361
$204.43Legal Blood Draw
$33.33Magnesium, Urine
$28.15Normal saline solution infus J7030
$3.70OTA Therapeutic Activities Charge
$165.18OT TH Therapeutic Exercise Chg
$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.