CPT J2765
The standard charge for Injection, metoclopramide hcl, up to 10 mg is $8.00. 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
$8.00Insurance Discount
-$0.40Price Negotiated by Insurer
$7.60Deductible 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.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65ER INJ SQ/IM
$93.10ER ROOM/OP ROOM EXTENDED 99284
$1,159.95ER ROOM/OP ROOM INTERMEDIATE 99283
$720.10HYDRATION IV INFUSION, ADD-ON
$108.30IV - NACL 0.9% [1000 ML]
$20.90IV PUSH EA ADD'L DRUG
$139.65IV PUSH;INITIAL
$185.25KETOROLAC INJ [15 MG/ML]
$24.70SUMATRIPTAN INJ [6 MG/0.5 ML]
$271.70This 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
$8.00Insurance Discount
-$0.80Price Negotiated by Insurer
$7.20Deductible 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.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30ER INJ SQ/IM
$88.20ER ROOM/OP ROOM EXTENDED 99284
$1,098.90ER ROOM/OP ROOM INTERMEDIATE 99283
$682.20HYDRATION IV INFUSION, ADD-ON
$102.60IV - NACL 0.9% [1000 ML]
$19.80IV PUSH EA ADD'L DRUG
$132.30IV PUSH;INITIAL
$175.50KETOROLAC INJ [15 MG/ML]
$23.40SUMATRIPTAN INJ [6 MG/0.5 ML]
$257.40This 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
$8.00Insurance Discount
-$0.80Price Negotiated by Insurer
$7.20Deductible 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.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30ER INJ SQ/IM
$88.20ER ROOM/OP ROOM EXTENDED 99284
$1,098.90ER ROOM/OP ROOM INTERMEDIATE 99283
$682.20HYDRATION IV INFUSION, ADD-ON
$102.60IV - NACL 0.9% [1000 ML]
$19.80IV PUSH EA ADD'L DRUG
$132.30IV PUSH;INITIAL
$175.50KETOROLAC INJ [15 MG/ML]
$23.40SUMATRIPTAN INJ [6 MG/0.5 ML]
$257.40This 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
$8.00Insurance Discount
-$0.40Price Negotiated by Insurer
$7.60Deductible 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.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65ER INJ SQ/IM
$93.10ER ROOM/OP ROOM EXTENDED 99284
$1,159.95ER ROOM/OP ROOM INTERMEDIATE 99283
$720.10HYDRATION IV INFUSION, ADD-ON
$108.30IV - NACL 0.9% [1000 ML]
$20.90IV PUSH EA ADD'L DRUG
$139.65IV PUSH;INITIAL
$185.25KETOROLAC INJ [15 MG/ML]
$24.70SUMATRIPTAN INJ [6 MG/0.5 ML]
$271.70This 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
$8.00Insurance Discount
-$0.80Price Negotiated by Insurer
$7.20Deductible 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.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30ER INJ SQ/IM
$88.20ER ROOM/OP ROOM EXTENDED 99284
$1,098.90ER ROOM/OP ROOM INTERMEDIATE 99283
$682.20HYDRATION IV INFUSION, ADD-ON
$102.60IV - NACL 0.9% [1000 ML]
$19.80IV PUSH EA ADD'L DRUG
$132.30IV PUSH;INITIAL
$175.50KETOROLAC INJ [15 MG/ML]
$23.40SUMATRIPTAN INJ [6 MG/0.5 ML]
$257.40This 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
$8.00Insurance Discount
-$0.80Price Negotiated by Insurer
$7.20Deductible 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.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30ER INJ SQ/IM
$88.20ER ROOM/OP ROOM EXTENDED 99284
$1,098.90ER ROOM/OP ROOM INTERMEDIATE 99283
$682.20HYDRATION IV INFUSION, ADD-ON
$102.60IV - NACL 0.9% [1000 ML]
$19.80IV PUSH EA ADD'L DRUG
$132.30IV PUSH;INITIAL
$175.50KETOROLAC INJ [15 MG/ML]
$23.40SUMATRIPTAN INJ [6 MG/0.5 ML]
$257.40This 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
$8.00Insurance Discount
-$0.40Price Negotiated by Insurer
$7.60Deductible 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.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65ER INJ SQ/IM
$93.10ER ROOM/OP ROOM EXTENDED 99284
$1,159.95ER ROOM/OP ROOM INTERMEDIATE 99283
$720.10HYDRATION IV INFUSION, ADD-ON
$108.30IV - NACL 0.9% [1000 ML]
$20.90IV PUSH EA ADD'L DRUG
$139.65IV PUSH;INITIAL
$185.25KETOROLAC INJ [15 MG/ML]
$24.70SUMATRIPTAN INJ [6 MG/0.5 ML]
$271.70This 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
$8.00Insurance Discount
$0.00Price Negotiated by Insurer
$8.00Deductible 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.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$107.00ER INJ SQ/IM
$98.00ER ROOM/OP ROOM EXTENDED 99284
$1,221.00ER ROOM/OP ROOM INTERMEDIATE 99283
$758.00HYDRATION IV INFUSION, ADD-ON
$114.00IV - NACL 0.9% [1000 ML]
$22.00IV PUSH EA ADD'L DRUG
$147.00IV PUSH;INITIAL
$195.00KETOROLAC INJ [15 MG/ML]
$26.00SUMATRIPTAN INJ [6 MG/0.5 ML]
$286.00This 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
$8.00Insurance Discount
-$0.80Price Negotiated by Insurer
$7.20Deductible 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.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30ER INJ SQ/IM
$88.20ER ROOM/OP ROOM EXTENDED 99284
$1,098.90ER ROOM/OP ROOM INTERMEDIATE 99283
$682.20HYDRATION IV INFUSION, ADD-ON
$102.60IV - NACL 0.9% [1000 ML]
$19.80IV PUSH EA ADD'L DRUG
$132.30IV PUSH;INITIAL
$175.50KETOROLAC INJ [15 MG/ML]
$23.40SUMATRIPTAN INJ [6 MG/0.5 ML]
$257.40This 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
$8.00Insurance Discount
-$0.40Price Negotiated by Insurer
$7.60Deductible 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.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65ER INJ SQ/IM
$93.10ER ROOM/OP ROOM EXTENDED 99284
$1,159.95ER ROOM/OP ROOM INTERMEDIATE 99283
$720.10HYDRATION IV INFUSION, ADD-ON
$108.30IV - NACL 0.9% [1000 ML]
$20.90IV PUSH EA ADD'L DRUG
$139.65IV PUSH;INITIAL
$185.25KETOROLAC INJ [15 MG/ML]
$24.70SUMATRIPTAN INJ [6 MG/0.5 ML]
$271.70This 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
$8.00Insurance Discount
-$0.80Price Negotiated by Insurer
$7.20Deductible 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.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30ER INJ SQ/IM
$88.20ER ROOM/OP ROOM EXTENDED 99284
$1,098.90ER ROOM/OP ROOM INTERMEDIATE 99283
$682.20HYDRATION IV INFUSION, ADD-ON
$102.60IV - NACL 0.9% [1000 ML]
$19.80IV PUSH EA ADD'L DRUG
$132.30IV PUSH;INITIAL
$175.50KETOROLAC INJ [15 MG/ML]
$23.40SUMATRIPTAN INJ [6 MG/0.5 ML]
$257.40This 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
$8.00Insurance Discount
-$0.64Price Negotiated by Insurer
$7.36Deductible 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.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$98.44ER INJ SQ/IM
$90.16ER ROOM/OP ROOM EXTENDED 99284
$1,123.32ER ROOM/OP ROOM INTERMEDIATE 99283
$697.36HYDRATION IV INFUSION, ADD-ON
$104.88IV - NACL 0.9% [1000 ML]
$20.24IV PUSH EA ADD'L DRUG
$135.24IV PUSH;INITIAL
$179.40KETOROLAC INJ [15 MG/ML]
$23.92SUMATRIPTAN INJ [6 MG/0.5 ML]
$263.12This 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
$8.00Insurance Discount
-$2.40Price Negotiated by Insurer
$5.60Deductible 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.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$74.90ER INJ SQ/IM
$68.60ER ROOM/OP ROOM EXTENDED 99284
$854.70ER ROOM/OP ROOM INTERMEDIATE 99283
$530.60HYDRATION IV INFUSION, ADD-ON
$79.80IV - NACL 0.9% [1000 ML]
$15.40IV PUSH EA ADD'L DRUG
$102.90IV PUSH;INITIAL
$136.50KETOROLAC INJ [15 MG/ML]
$18.20SUMATRIPTAN INJ [6 MG/0.5 ML]
$200.20This 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
$8.00Insurance Discount
-$0.40Price Negotiated by Insurer
$7.60Deductible 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.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65ER INJ SQ/IM
$93.10ER ROOM/OP ROOM EXTENDED 99284
$1,159.95ER ROOM/OP ROOM INTERMEDIATE 99283
$720.10HYDRATION IV INFUSION, ADD-ON
$108.30IV - NACL 0.9% [1000 ML]
$20.90IV PUSH EA ADD'L DRUG
$139.65IV PUSH;INITIAL
$185.25KETOROLAC INJ [15 MG/ML]
$24.70SUMATRIPTAN INJ [6 MG/0.5 ML]
$271.70This 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
$8.00Insurance Discount
-$0.24Price Negotiated by Insurer
$7.76Deductible 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.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$103.79ER INJ SQ/IM
$95.06ER ROOM/OP ROOM EXTENDED 99284
$1,184.37ER ROOM/OP ROOM INTERMEDIATE 99283
$735.26HYDRATION IV INFUSION, ADD-ON
$110.58IV - NACL 0.9% [1000 ML]
$21.34IV PUSH EA ADD'L DRUG
$142.59IV PUSH;INITIAL
$189.15KETOROLAC INJ [15 MG/ML]
$25.22SUMATRIPTAN INJ [6 MG/0.5 ML]
$277.42This 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
$8.00Insurance Discount
-$0.40Price Negotiated by Insurer
$7.60Deductible 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.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65ER INJ SQ/IM
$93.10ER ROOM/OP ROOM EXTENDED 99284
$1,159.95ER ROOM/OP ROOM INTERMEDIATE 99283
$720.10HYDRATION IV INFUSION, ADD-ON
$108.30IV - NACL 0.9% [1000 ML]
$20.90IV PUSH EA ADD'L DRUG
$139.65IV PUSH;INITIAL
$185.25KETOROLAC INJ [15 MG/ML]
$24.70SUMATRIPTAN INJ [6 MG/0.5 ML]
$271.70This 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
$8.00Insurance Discount
-$0.40Price Negotiated by Insurer
$7.60Deductible 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.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65ER INJ SQ/IM
$93.10ER ROOM/OP ROOM EXTENDED 99284
$1,159.95ER ROOM/OP ROOM INTERMEDIATE 99283
$720.10HYDRATION IV INFUSION, ADD-ON
$108.30IV - NACL 0.9% [1000 ML]
$20.90IV PUSH EA ADD'L DRUG
$139.65IV PUSH;INITIAL
$185.25KETOROLAC INJ [15 MG/ML]
$24.70SUMATRIPTAN INJ [6 MG/0.5 ML]
$271.70This 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.