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CPT 71250
The standard charge for Computed tomography, thorax, diagnostic; without contrast material is $1,507.00. 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
321 Madison St., Sheridan, MT, 59749CONTACT
(406) 842-5453 Visit WebsiteRuby Valley Medical Center 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, Ruby Valley Medical Center 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-Ruby Valley Medical Center 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 406-842-5453 or via our contact form here.
Choose a plan to view the insurance rate estimate.
Total estimated charges
$1,507.00Insurance Discount
-$75.35Price Negotiated by Insurer
$1,431.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AZITHROMYCIN 500MG INJ
$34.20.CAPILLARY SAMPLE COLLECTION
$25.65cefTRIAXone (ROCEPHIN) 2GM INJ
$24.70.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65COMPREHENSIVE METABOLIC PANEL
$204.25C-REACTIVE PROTEIN
$86.45CT HEAD WO CONTRAST
$1,360.40ER ROOM/OP ROOM COMPREHENSIVE 99285
$1,634.00HYDRATION IV INFUSION, ADD-ON
$108.30IV - NACL 0.9% [1000 ML]
$20.90IV PUSH EA ADD'L DRUG
$139.65LAB TROPONIN
$107.35LAB VENIPUNCTURE
$23.75LACTIC ACID
$135.85MORPHINE INJ [4 MG/ML] VL
$24.70NS 100mL Charge only
$8.55PROTHROMBIN TIME (005199)
$6.65XR CHEST CHILD 1 VIEW
$186.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,507.00Insurance Discount
-$150.70Price Negotiated by Insurer
$1,356.30Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AZITHROMYCIN 500MG INJ
$32.40.CAPILLARY SAMPLE COLLECTION
$24.30cefTRIAXone (ROCEPHIN) 2GM INJ
$23.40.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30COMPREHENSIVE METABOLIC PANEL
$193.50C-REACTIVE PROTEIN
$81.90CT HEAD WO CONTRAST
$1,288.80ER ROOM/OP ROOM COMPREHENSIVE 99285
$1,548.00HYDRATION IV INFUSION, ADD-ON
$102.60IV - NACL 0.9% [1000 ML]
$19.80IV PUSH EA ADD'L DRUG
$132.30LAB TROPONIN
$101.70LAB VENIPUNCTURE
$22.50LACTIC ACID
$128.70MORPHINE INJ [4 MG/ML] VL
$23.40NS 100mL Charge only
$8.10PROTHROMBIN TIME (005199)
$6.30XR CHEST CHILD 1 VIEW
$176.40This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,507.00Insurance Discount
-$150.70Price Negotiated by Insurer
$1,356.30Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AZITHROMYCIN 500MG INJ
$32.40.CAPILLARY SAMPLE COLLECTION
$24.30cefTRIAXone (ROCEPHIN) 2GM INJ
$23.40.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30COMPREHENSIVE METABOLIC PANEL
$193.50C-REACTIVE PROTEIN
$81.90CT HEAD WO CONTRAST
$1,288.80ER ROOM/OP ROOM COMPREHENSIVE 99285
$1,548.00HYDRATION IV INFUSION, ADD-ON
$102.60IV - NACL 0.9% [1000 ML]
$19.80IV PUSH EA ADD'L DRUG
$132.30LAB TROPONIN
$101.70LAB VENIPUNCTURE
$22.50LACTIC ACID
$128.70MORPHINE INJ [4 MG/ML] VL
$23.40NS 100mL Charge only
$8.10PROTHROMBIN TIME (005199)
$6.30XR CHEST CHILD 1 VIEW
$176.40This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,507.00Insurance Discount
-$75.35Price Negotiated by Insurer
$1,431.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AZITHROMYCIN 500MG INJ
$34.20.CAPILLARY SAMPLE COLLECTION
$25.65cefTRIAXone (ROCEPHIN) 2GM INJ
$24.70.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65COMPREHENSIVE METABOLIC PANEL
$204.25C-REACTIVE PROTEIN
$86.45CT HEAD WO CONTRAST
$1,360.40ER ROOM/OP ROOM COMPREHENSIVE 99285
$1,634.00HYDRATION IV INFUSION, ADD-ON
$108.30IV - NACL 0.9% [1000 ML]
$20.90IV PUSH EA ADD'L DRUG
$139.65LAB TROPONIN
$107.35LAB VENIPUNCTURE
$23.75LACTIC ACID
$135.85MORPHINE INJ [4 MG/ML] VL
$24.70NS 100mL Charge only
$8.55PROTHROMBIN TIME (005199)
$6.65XR CHEST CHILD 1 VIEW
$186.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,507.00Insurance Discount
-$150.70Price Negotiated by Insurer
$1,356.30Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AZITHROMYCIN 500MG INJ
$32.40.CAPILLARY SAMPLE COLLECTION
$24.30cefTRIAXone (ROCEPHIN) 2GM INJ
$23.40.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30COMPREHENSIVE METABOLIC PANEL
$193.50C-REACTIVE PROTEIN
$81.90CT HEAD WO CONTRAST
$1,288.80ER ROOM/OP ROOM COMPREHENSIVE 99285
$1,548.00HYDRATION IV INFUSION, ADD-ON
$102.60IV - NACL 0.9% [1000 ML]
$19.80IV PUSH EA ADD'L DRUG
$132.30LAB TROPONIN
$101.70LAB VENIPUNCTURE
$22.50LACTIC ACID
$128.70MORPHINE INJ [4 MG/ML] VL
$23.40NS 100mL Charge only
$8.10PROTHROMBIN TIME (005199)
$6.30XR CHEST CHILD 1 VIEW
$176.40This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,507.00Insurance Discount
-$150.70Price Negotiated by Insurer
$1,356.30Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AZITHROMYCIN 500MG INJ
$32.40.CAPILLARY SAMPLE COLLECTION
$24.30cefTRIAXone (ROCEPHIN) 2GM INJ
$23.40.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30COMPREHENSIVE METABOLIC PANEL
$193.50C-REACTIVE PROTEIN
$81.90CT HEAD WO CONTRAST
$1,288.80ER ROOM/OP ROOM COMPREHENSIVE 99285
$1,548.00HYDRATION IV INFUSION, ADD-ON
$102.60IV - NACL 0.9% [1000 ML]
$19.80IV PUSH EA ADD'L DRUG
$132.30LAB TROPONIN
$101.70LAB VENIPUNCTURE
$22.50LACTIC ACID
$128.70MORPHINE INJ [4 MG/ML] VL
$23.40NS 100mL Charge only
$8.10PROTHROMBIN TIME (005199)
$6.30XR CHEST CHILD 1 VIEW
$176.40This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,507.00Insurance Discount
-$75.35Price Negotiated by Insurer
$1,431.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AZITHROMYCIN 500MG INJ
$34.20.CAPILLARY SAMPLE COLLECTION
$25.65cefTRIAXone (ROCEPHIN) 2GM INJ
$24.70.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65COMPREHENSIVE METABOLIC PANEL
$204.25C-REACTIVE PROTEIN
$86.45CT HEAD WO CONTRAST
$1,360.40ER ROOM/OP ROOM COMPREHENSIVE 99285
$1,634.00HYDRATION IV INFUSION, ADD-ON
$108.30IV - NACL 0.9% [1000 ML]
$20.90IV PUSH EA ADD'L DRUG
$139.65LAB TROPONIN
$107.35LAB VENIPUNCTURE
$23.75LACTIC ACID
$135.85MORPHINE INJ [4 MG/ML] VL
$24.70NS 100mL Charge only
$8.55PROTHROMBIN TIME (005199)
$6.65XR CHEST CHILD 1 VIEW
$186.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,507.00Insurance Discount
$0.00Price Negotiated by Insurer
$1,507.00Deductible 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.
AZITHROMYCIN 500MG INJ
$36.00.CAPILLARY SAMPLE COLLECTION
$27.00cefTRIAXone (ROCEPHIN) 2GM INJ
$26.00.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$107.00COMPREHENSIVE METABOLIC PANEL
$215.00C-REACTIVE PROTEIN
$91.00CT HEAD WO CONTRAST
$1,432.00ER ROOM/OP ROOM COMPREHENSIVE 99285
$1,720.00HYDRATION IV INFUSION, ADD-ON
$114.00IV - NACL 0.9% [1000 ML]
$22.00IV PUSH EA ADD'L DRUG
$147.00LAB TROPONIN
$113.00LAB VENIPUNCTURE
$25.00LACTIC ACID
$143.00MORPHINE INJ [4 MG/ML] VL
$26.00NS 100mL Charge only
$9.00PROTHROMBIN TIME (005199)
$7.00XR CHEST CHILD 1 VIEW
$196.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,507.00Insurance Discount
-$150.70Price Negotiated by Insurer
$1,356.30Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AZITHROMYCIN 500MG INJ
$32.40.CAPILLARY SAMPLE COLLECTION
$24.30cefTRIAXone (ROCEPHIN) 2GM INJ
$23.40.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30COMPREHENSIVE METABOLIC PANEL
$193.50C-REACTIVE PROTEIN
$81.90CT HEAD WO CONTRAST
$1,288.80ER ROOM/OP ROOM COMPREHENSIVE 99285
$1,548.00HYDRATION IV INFUSION, ADD-ON
$102.60IV - NACL 0.9% [1000 ML]
$19.80IV PUSH EA ADD'L DRUG
$132.30LAB TROPONIN
$101.70LAB VENIPUNCTURE
$22.50LACTIC ACID
$128.70MORPHINE INJ [4 MG/ML] VL
$23.40NS 100mL Charge only
$8.10PROTHROMBIN TIME (005199)
$6.30XR CHEST CHILD 1 VIEW
$176.40This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,507.00Insurance Discount
-$75.35Price Negotiated by Insurer
$1,431.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AZITHROMYCIN 500MG INJ
$34.20.CAPILLARY SAMPLE COLLECTION
$25.65cefTRIAXone (ROCEPHIN) 2GM INJ
$24.70.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65COMPREHENSIVE METABOLIC PANEL
$204.25C-REACTIVE PROTEIN
$86.45CT HEAD WO CONTRAST
$1,360.40ER ROOM/OP ROOM COMPREHENSIVE 99285
$1,634.00HYDRATION IV INFUSION, ADD-ON
$108.30IV - NACL 0.9% [1000 ML]
$20.90IV PUSH EA ADD'L DRUG
$139.65LAB TROPONIN
$107.35LAB VENIPUNCTURE
$23.75LACTIC ACID
$135.85MORPHINE INJ [4 MG/ML] VL
$24.70NS 100mL Charge only
$8.55PROTHROMBIN TIME (005199)
$6.65XR CHEST CHILD 1 VIEW
$186.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,507.00Insurance Discount
-$150.70Price Negotiated by Insurer
$1,356.30Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AZITHROMYCIN 500MG INJ
$32.40.CAPILLARY SAMPLE COLLECTION
$24.30cefTRIAXone (ROCEPHIN) 2GM INJ
$23.40.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30COMPREHENSIVE METABOLIC PANEL
$193.50C-REACTIVE PROTEIN
$81.90CT HEAD WO CONTRAST
$1,288.80ER ROOM/OP ROOM COMPREHENSIVE 99285
$1,548.00HYDRATION IV INFUSION, ADD-ON
$102.60IV - NACL 0.9% [1000 ML]
$19.80IV PUSH EA ADD'L DRUG
$132.30LAB TROPONIN
$101.70LAB VENIPUNCTURE
$22.50LACTIC ACID
$128.70MORPHINE INJ [4 MG/ML] VL
$23.40NS 100mL Charge only
$8.10PROTHROMBIN TIME (005199)
$6.30XR CHEST CHILD 1 VIEW
$176.40This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,507.00Insurance Discount
-$120.56Price Negotiated by Insurer
$1,386.44Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AZITHROMYCIN 500MG INJ
$33.12.CAPILLARY SAMPLE COLLECTION
$24.84cefTRIAXone (ROCEPHIN) 2GM INJ
$23.92.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$98.44COMPREHENSIVE METABOLIC PANEL
$197.80C-REACTIVE PROTEIN
$83.72CT HEAD WO CONTRAST
$1,317.44ER ROOM/OP ROOM COMPREHENSIVE 99285
$1,582.40HYDRATION IV INFUSION, ADD-ON
$104.88IV - NACL 0.9% [1000 ML]
$20.24IV PUSH EA ADD'L DRUG
$135.24LAB TROPONIN
$103.96LAB VENIPUNCTURE
$23.00LACTIC ACID
$131.56MORPHINE INJ [4 MG/ML] VL
$23.92NS 100mL Charge only
$8.28PROTHROMBIN TIME (005199)
$6.44XR CHEST CHILD 1 VIEW
$180.32This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,507.00Insurance Discount
-$452.10Price Negotiated by Insurer
$1,054.90Deductible 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.
AZITHROMYCIN 500MG INJ
$25.20.CAPILLARY SAMPLE COLLECTION
$18.90cefTRIAXone (ROCEPHIN) 2GM INJ
$18.20.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$74.90COMPREHENSIVE METABOLIC PANEL
$150.50C-REACTIVE PROTEIN
$63.70CT HEAD WO CONTRAST
$1,002.40ER ROOM/OP ROOM COMPREHENSIVE 99285
$1,204.00HYDRATION IV INFUSION, ADD-ON
$79.80IV - NACL 0.9% [1000 ML]
$15.40IV PUSH EA ADD'L DRUG
$102.90LAB TROPONIN
$79.10LAB VENIPUNCTURE
$17.50LACTIC ACID
$100.10MORPHINE INJ [4 MG/ML] VL
$18.20NS 100mL Charge only
$6.30PROTHROMBIN TIME (005199)
$4.90XR CHEST CHILD 1 VIEW
$137.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,507.00Insurance Discount
-$75.35Price Negotiated by Insurer
$1,431.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AZITHROMYCIN 500MG INJ
$34.20.CAPILLARY SAMPLE COLLECTION
$25.65cefTRIAXone (ROCEPHIN) 2GM INJ
$24.70.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65COMPREHENSIVE METABOLIC PANEL
$204.25C-REACTIVE PROTEIN
$86.45CT HEAD WO CONTRAST
$1,360.40ER ROOM/OP ROOM COMPREHENSIVE 99285
$1,634.00HYDRATION IV INFUSION, ADD-ON
$108.30IV - NACL 0.9% [1000 ML]
$20.90IV PUSH EA ADD'L DRUG
$139.65LAB TROPONIN
$107.35LAB VENIPUNCTURE
$23.75LACTIC ACID
$135.85MORPHINE INJ [4 MG/ML] VL
$24.70NS 100mL Charge only
$8.55PROTHROMBIN TIME (005199)
$6.65XR CHEST CHILD 1 VIEW
$186.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,507.00Insurance Discount
-$45.21Price Negotiated by Insurer
$1,461.79Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AZITHROMYCIN 500MG INJ
$34.92.CAPILLARY SAMPLE COLLECTION
$26.19cefTRIAXone (ROCEPHIN) 2GM INJ
$25.22.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$103.79COMPREHENSIVE METABOLIC PANEL
$208.55C-REACTIVE PROTEIN
$88.27CT HEAD WO CONTRAST
$1,389.04ER ROOM/OP ROOM COMPREHENSIVE 99285
$1,668.40HYDRATION IV INFUSION, ADD-ON
$110.58IV - NACL 0.9% [1000 ML]
$21.34IV PUSH EA ADD'L DRUG
$142.59LAB TROPONIN
$109.61LAB VENIPUNCTURE
$24.25LACTIC ACID
$138.71MORPHINE INJ [4 MG/ML] VL
$25.22NS 100mL Charge only
$8.73PROTHROMBIN TIME (005199)
$6.79XR CHEST CHILD 1 VIEW
$190.12This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,507.00Insurance Discount
-$75.35Price Negotiated by Insurer
$1,431.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AZITHROMYCIN 500MG INJ
$34.20.CAPILLARY SAMPLE COLLECTION
$25.65cefTRIAXone (ROCEPHIN) 2GM INJ
$24.70.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65COMPREHENSIVE METABOLIC PANEL
$204.25C-REACTIVE PROTEIN
$86.45CT HEAD WO CONTRAST
$1,360.40ER ROOM/OP ROOM COMPREHENSIVE 99285
$1,634.00HYDRATION IV INFUSION, ADD-ON
$108.30IV - NACL 0.9% [1000 ML]
$20.90IV PUSH EA ADD'L DRUG
$139.65LAB TROPONIN
$107.35LAB VENIPUNCTURE
$23.75LACTIC ACID
$135.85MORPHINE INJ [4 MG/ML] VL
$24.70NS 100mL Charge only
$8.55PROTHROMBIN TIME (005199)
$6.65XR CHEST CHILD 1 VIEW
$186.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,507.00Insurance Discount
-$75.35Price Negotiated by Insurer
$1,431.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
AZITHROMYCIN 500MG INJ
$34.20.CAPILLARY SAMPLE COLLECTION
$25.65cefTRIAXone (ROCEPHIN) 2GM INJ
$24.70.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65COMPREHENSIVE METABOLIC PANEL
$204.25C-REACTIVE PROTEIN
$86.45CT HEAD WO CONTRAST
$1,360.40ER ROOM/OP ROOM COMPREHENSIVE 99285
$1,634.00HYDRATION IV INFUSION, ADD-ON
$108.30IV - NACL 0.9% [1000 ML]
$20.90IV PUSH EA ADD'L DRUG
$139.65LAB TROPONIN
$107.35LAB VENIPUNCTURE
$23.75LACTIC ACID
$135.85MORPHINE INJ [4 MG/ML] VL
$24.70NS 100mL Charge only
$8.55PROTHROMBIN TIME (005199)
$6.65XR CHEST CHILD 1 VIEW
$186.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.