
CPT 76000
The standard charge for Flouroscopy, or x-ray "movie" that takes less than an hour is $1,140.00. 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
901 Adams Street, Afton, WY, 83110CONTACT
(307) 885-5800 Visit WebsiteStar Valley Health 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, Star Valley Health 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-Star Valley Health 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 866-641-1039.
Choose a plan to view the insurance rate estimate.
Total estimated charges
$1,140.00Insurance Discount
-$22.80Price Negotiated by Insurer
$1,117.20Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$15.68CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$42.66FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$19.19HC CAMS DEXAMETHASONE SODIUM PHOS
$25.28ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$17.22PROPOFOL INFUSION 10 MG/ML [40840026]
$1.18This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$387.60Price Negotiated by Insurer
$752.40Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$16.50CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$28.72FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$11.48HC CAMS DEXAMETHASONE SODIUM PHOS
$12.45ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$10.85PROPOFOL INFUSION 10 MG/ML [40840026]
$0.79This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$45.60Price Negotiated by Insurer
$1,094.40Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$24.00CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$41.78FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$16.70HC CAMS DEXAMETHASONE SODIUM PHOS
$18.12ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$15.78PROPOFOL INFUSION 10 MG/ML [40840026]
$1.15This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$45.60Price Negotiated by Insurer
$1,094.40Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$24.00CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$41.78FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$16.70HC CAMS DEXAMETHASONE SODIUM PHOS
$18.12ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$15.78PROPOFOL INFUSION 10 MG/ML [40840026]
$1.15This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$22.80Price Negotiated by Insurer
$1,117.20Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$24.50CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$42.65FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$19.19HC CAMS DEXAMETHASONE SODIUM PHOS
$21.56ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$17.22PROPOFOL INFUSION 10 MG/ML [40840026]
$1.18This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$204.06Price Negotiated by Insurer
$935.94Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$20.52CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$35.73FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$14.29HC CAMS DEXAMETHASONE SODIUM PHOS
$15.49ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$13.50PROPOFOL INFUSION 10 MG/ML [40840026]
$0.99This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$342.00Price Negotiated by Insurer
$798.00Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$18.38CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$30.47FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$13.47HC CAMS DEXAMETHASONE SODIUM PHOS
$15.40ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$11.51PROPOFOL INFUSION 10 MG/ML [40840026]
$0.84This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$34.20Price Negotiated by Insurer
$1,105.80Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$24.25CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$42.22FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$18.99HC CAMS DEXAMETHASONE SODIUM PHOS
$21.34ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$15.95PROPOFOL INFUSION 10 MG/ML [40840026]
$1.16This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$22.80Price Negotiated by Insurer
$1,117.20Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$24.50CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$42.65FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$19.19HC CAMS DEXAMETHASONE SODIUM PHOS
$18.49ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$16.11PROPOFOL INFUSION 10 MG/ML [40840026]
$1.18This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$57.00Price Negotiated by Insurer
$1,083.00Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$15.20CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$41.34FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$17.88HC CAMS DEXAMETHASONE SODIUM PHOS
$17.93ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$15.62PROPOFOL INFUSION 10 MG/ML [40840026]
$1.14This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$57.00Price Negotiated by Insurer
$1,083.00Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$23.75CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$41.34FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$16.53HC CAMS DEXAMETHASONE SODIUM PHOS
$20.90ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$15.62PROPOFOL INFUSION 10 MG/ML [40840026]
$1.14This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$57.00Price Negotiated by Insurer
$1,083.00Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$24.94CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$20.52FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$18.60HC CAMS DEXAMETHASONE SODIUM PHOS
$24.51ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$15.62PROPOFOL INFUSION 10 MG/ML [40840026]
$1.14This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$478.80Price Negotiated by Insurer
$661.20Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$14.50CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$25.24FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$9.77HC CAMS DEXAMETHASONE SODIUM PHOS
$4.64ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$9.54PROPOFOL INFUSION 10 MG/ML [40840026]
$0.70This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
$0.00Price Negotiated by Insurer
$1,140.00Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$26.25CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$43.53FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$18.82HC CAMS DEXAMETHASONE SODIUM PHOS
$8.00ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$16.44PROPOFOL INFUSION 10 MG/ML [40840026]
$1.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$34.20Price Negotiated by Insurer
$1,105.80Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$15.52CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$20.95FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$18.26HC CAMS DEXAMETHASONE SODIUM PHOS
$18.30ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$15.95PROPOFOL INFUSION 10 MG/ML [40840026]
$1.16This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$511.86Price Negotiated by Insurer
$628.14Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$13.78CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$23.99FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$10.79HC CAMS DEXAMETHASONE SODIUM PHOS
$22.73ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$9.06PROPOFOL INFUSION 10 MG/ML [40840026]
$0.66This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$22.80Price Negotiated by Insurer
$1,117.20Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$24.50CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$34.77FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$18.44HC CAMS DEXAMETHASONE SODIUM PHOS
$18.49ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$16.11PROPOFOL INFUSION 10 MG/ML [40840026]
$1.18This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$114.00Price Negotiated by Insurer
$1,026.00Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$23.62CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$39.18FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$16.94HC CAMS DEXAMETHASONE SODIUM PHOS
$16.98ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$15.81PROPOFOL INFUSION 10 MG/ML [40840026]
$1.08This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$22.80Price Negotiated by Insurer
$1,117.20Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$24.50CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$34.77FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$18.44HC CAMS DEXAMETHASONE SODIUM PHOS
$7.84ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$16.11PROPOFOL INFUSION 10 MG/ML [40840026]
$1.18This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$285.00Price Negotiated by Insurer
$855.00Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$18.75CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$32.64FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$14.44HC CAMS DEXAMETHASONE SODIUM PHOS
$14.15ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$12.33PROPOFOL INFUSION 10 MG/ML [40840026]
$0.90This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$478.80Price Negotiated by Insurer
$661.20Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$14.50CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$25.24FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$10.92HC CAMS DEXAMETHASONE SODIUM PHOS
$14.96ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$9.54PROPOFOL INFUSION 10 MG/ML [40840026]
$0.70This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$148.20Price Negotiated by Insurer
$991.80Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$21.75CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$37.87FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$17.03HC CAMS DEXAMETHASONE SODIUM PHOS
$16.42ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$15.29PROPOFOL INFUSION 10 MG/ML [40840026]
$1.04This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$478.80Price Negotiated by Insurer
$661.20Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$15.22CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$12.53FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$9.86HC CAMS DEXAMETHASONE SODIUM PHOS
$10.94ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$10.19PROPOFOL INFUSION 10 MG/ML [40840026]
$0.70This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$22.80Price Negotiated by Insurer
$1,117.20Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$24.50CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$42.65FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$18.44HC CAMS DEXAMETHASONE SODIUM PHOS
$18.49ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$16.11PROPOFOL INFUSION 10 MG/ML [40840026]
$1.18This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.
Total estimated charges
$1,140.00Insurance Discount
-$57.00Price Negotiated by Insurer
$1,083.00Deductible 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.
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [28413]
$15.20CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [454]
$33.71FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [14425]
$17.88HC CAMS DEXAMETHASONE SODIUM PHOS
$39.19ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [42439]
$15.62PROPOFOL INFUSION 10 MG/ML [40840026]
$1.14This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Star Valley Health so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Star Valley Health directly at (307) 885-5800.