CPT 96367
The standard charge for Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion of a new drug/substance, up to 1 hour (List separately in addition to code for primary procedure) is $230.00. 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
2350 Hospital Drive, Webster City, IA, 50595CONTACT
(515) 832-9400 Visit WebsiteVan Diest 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, Van Diest 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-Van Diest 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 515-832-9400.
Choose a plan to view the insurance rate estimate.
Total estimated charges
$230.00Insurance Discount
-$23.00Price Negotiated by Insurer
$207.00Deductible 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.
ADM IVP TX EA ADD'L MED
$57.60CBC WITH DIFF
$72.00cefTRIAXone 500 mg Inj SDV [VDMC]
$21.47COMPREHENSIVE METABOLIC PANEL
$178.20C-REACTIVE PROTEIN-HIGH SENS
$74.70EKG SUBSQ DIFF DR
$144.90INF TX HYDRATION EA ADDL HR
$136.80INF TX MED 1ST HR
$343.80LABOR PER HOUR
$55.80lactase 3000 units Tab [VDMC]
$1.25LEVEL 4
$639.90LEVEL 5
$937.80Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$60.12VENIPUNCTURE
$18.90This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Insurance Discount
-$23.00Price Negotiated by Insurer
$207.00Deductible 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.
ADM IVP TX EA ADD'L MED
$57.60CBC WITH DIFF
$72.00cefTRIAXone 500 mg Inj SDV [VDMC]
$21.47COMPREHENSIVE METABOLIC PANEL
$178.20C-REACTIVE PROTEIN-HIGH SENS
$74.70EKG SUBSQ DIFF DR
$144.90INF TX HYDRATION EA ADDL HR
$136.80INF TX MED 1ST HR
$343.80LABOR PER HOUR
$55.80lactase 3000 units Tab [VDMC]
$1.25LEVEL 4
$639.90LEVEL 5
$937.80Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$60.12VENIPUNCTURE
$18.90This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Insurance Discount
-$98.90Price Negotiated by Insurer
$131.10Deductible 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.
ADM IVP TX EA ADD'L MED
$36.48CBC WITH DIFF
$45.60cefTRIAXone 500 mg Inj SDV [VDMC]
$13.60COMPREHENSIVE METABOLIC PANEL
$112.86C-REACTIVE PROTEIN-HIGH SENS
$47.31EKG SUBSQ DIFF DR
$91.77INF TX HYDRATION EA ADDL HR
$86.64INF TX MED 1ST HR
$217.74LABOR PER HOUR
$35.34lactase 3000 units Tab [VDMC]
$0.79LEVEL 4
$405.27LEVEL 5
$593.94Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$38.08VENIPUNCTURE
$11.97This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Insurance Discount
-$113.92Price Negotiated by Insurer
$116.08Deductible 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.
ADM IVP TX EA ADD'L MED
$32.30CBC WITH DIFF
$40.38cefTRIAXone 500 mg Inj SDV [VDMC]
$12.04COMPREHENSIVE METABOLIC PANEL
$99.93C-REACTIVE PROTEIN-HIGH SENS
$41.89EKG SUBSQ DIFF DR
$81.26INF TX HYDRATION EA ADDL HR
$76.71INF TX MED 1ST HR
$192.80LABOR PER HOUR
$31.29lactase 3000 units Tab [VDMC]
$0.70LEVEL 4
$358.84LEVEL 5
$525.90Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$33.71VENIPUNCTURE
$10.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Insurance Discount
-$113.85Price Negotiated by Insurer
$116.15Deductible 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.
ADM IVP TX EA ADD'L MED
$32.32CBC WITH DIFF
$40.40cefTRIAXone 500 mg Inj SDV [VDMC]
$12.05COMPREHENSIVE METABOLIC PANEL
$99.99C-REACTIVE PROTEIN-HIGH SENS
$41.92EKG SUBSQ DIFF DR
$81.30INF TX HYDRATION EA ADDL HR
$76.76INF TX MED 1ST HR
$192.91LABOR PER HOUR
$31.31lactase 3000 units Tab [VDMC]
$0.70LEVEL 4
$359.06LEVEL 5
$526.21Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$33.73VENIPUNCTURE
$10.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Insurance Discount
-$46.00Price Negotiated by Insurer
$184.00Deductible 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.
ADM IVP TX EA ADD'L MED
$51.20CBC WITH DIFF
$64.00cefTRIAXone 500 mg Inj SDV [VDMC]
$19.09COMPREHENSIVE METABOLIC PANEL
$158.40C-REACTIVE PROTEIN-HIGH SENS
$66.40EKG SUBSQ DIFF DR
$128.80INF TX HYDRATION EA ADDL HR
$121.60INF TX MED 1ST HR
$305.60LABOR PER HOUR
$49.60lactase 3000 units Tab [VDMC]
$1.11LEVEL 4
$568.80LEVEL 5
$833.60Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$53.44VENIPUNCTURE
$16.80This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Insurance Discount
-$57.50Price Negotiated by Insurer
$172.50Deductible 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.
ADM IVP TX EA ADD'L MED
$48.00CBC WITH DIFF
$60.00cefTRIAXone 500 mg Inj SDV [VDMC]
$17.90COMPREHENSIVE METABOLIC PANEL
$148.50C-REACTIVE PROTEIN-HIGH SENS
$62.25EKG SUBSQ DIFF DR
$120.75INF TX HYDRATION EA ADDL HR
$114.00INF TX MED 1ST HR
$286.50LABOR PER HOUR
$46.50lactase 3000 units Tab [VDMC]
$1.04LEVEL 4
$533.25LEVEL 5
$781.50Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$50.10VENIPUNCTURE
$15.75This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Insurance Discount
-$115.00Price Negotiated by Insurer
$115.00Deductible 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.
ADM IVP TX EA ADD'L MED
$32.00CBC WITH DIFF
$40.00cefTRIAXone 500 mg Inj SDV [VDMC]
$11.93COMPREHENSIVE METABOLIC PANEL
$99.00C-REACTIVE PROTEIN-HIGH SENS
$41.50EKG SUBSQ DIFF DR
$80.50INF TX HYDRATION EA ADDL HR
$76.00INF TX MED 1ST HR
$191.00LABOR PER HOUR
$31.00lactase 3000 units Tab [VDMC]
$0.70LEVEL 4
$355.50LEVEL 5
$521.00Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$33.40VENIPUNCTURE
$10.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Insurance Discount
-$115.05Price Negotiated by Insurer
$114.95Deductible 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.
ADM IVP TX EA ADD'L MED
$31.99CBC WITH DIFF
$39.98cefTRIAXone 500 mg Inj SDV [VDMC]
$11.93COMPREHENSIVE METABOLIC PANEL
$98.96C-REACTIVE PROTEIN-HIGH SENS
$41.48EKG SUBSQ DIFF DR
$80.47INF TX HYDRATION EA ADDL HR
$75.97INF TX MED 1ST HR
$190.92LABOR PER HOUR
$30.99lactase 3000 units Tab [VDMC]
$0.69LEVEL 4
$355.36LEVEL 5
$520.79Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$33.39VENIPUNCTURE
$10.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Insurance Discount
-$57.50Price Negotiated by Insurer
$172.50Deductible 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.
ADM IVP TX EA ADD'L MED
$48.00CBC WITH DIFF
$60.00cefTRIAXone 500 mg Inj SDV [VDMC]
$17.90COMPREHENSIVE METABOLIC PANEL
$148.50C-REACTIVE PROTEIN-HIGH SENS
$62.25EKG SUBSQ DIFF DR
$120.75INF TX HYDRATION EA ADDL HR
$114.00INF TX MED 1ST HR
$286.50LABOR PER HOUR
$46.50lactase 3000 units Tab [VDMC]
$1.04LEVEL 4
$533.25LEVEL 5
$781.50Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$50.10VENIPUNCTURE
$15.75This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Insurance Discount
-$115.00Price Negotiated by Insurer
$115.00Deductible 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.
ADM IVP TX EA ADD'L MED
$32.00CBC WITH DIFF
$40.00cefTRIAXone 500 mg Inj SDV [VDMC]
$11.93COMPREHENSIVE METABOLIC PANEL
$99.00C-REACTIVE PROTEIN-HIGH SENS
$41.50EKG SUBSQ DIFF DR
$80.50INF TX HYDRATION EA ADDL HR
$76.00INF TX MED 1ST HR
$191.00LABOR PER HOUR
$31.00lactase 3000 units Tab [VDMC]
$0.70LEVEL 4
$355.50LEVEL 5
$521.00Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$33.40VENIPUNCTURE
$10.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Insurance Discount
-$69.00Price Negotiated by Insurer
$161.00Deductible 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.
ADM IVP TX EA ADD'L MED
$44.80CBC WITH DIFF
$56.00cefTRIAXone 500 mg Inj SDV [VDMC]
$16.70COMPREHENSIVE METABOLIC PANEL
$138.60C-REACTIVE PROTEIN-HIGH SENS
$58.10EKG SUBSQ DIFF DR
$112.70INF TX HYDRATION EA ADDL HR
$106.40INF TX MED 1ST HR
$267.40LABOR PER HOUR
$43.40lactase 3000 units Tab [VDMC]
$0.97LEVEL 4
$497.70LEVEL 5
$729.40Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$46.76VENIPUNCTURE
$14.70This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Insurance Discount
-$113.28Price Negotiated by Insurer
$116.72Deductible 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.
ADM IVP TX EA ADD'L MED
$32.48CBC WITH DIFF
$40.60cefTRIAXone 500 mg Inj SDV [VDMC]
$12.11COMPREHENSIVE METABOLIC PANEL
$100.48C-REACTIVE PROTEIN-HIGH SENS
$42.12EKG SUBSQ DIFF DR
$81.71INF TX HYDRATION EA ADDL HR
$77.14INF TX MED 1ST HR
$193.86LABOR PER HOUR
$31.46lactase 3000 units Tab [VDMC]
$0.71LEVEL 4
$360.83LEVEL 5
$528.82Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$33.90VENIPUNCTURE
$10.66This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Insurance Discount
-$113.34Price Negotiated by Insurer
$116.66Deductible 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.
ADM IVP TX EA ADD'L MED
$32.46CBC WITH DIFF
$40.58cefTRIAXone 500 mg Inj SDV [VDMC]
$12.10COMPREHENSIVE METABOLIC PANEL
$100.43C-REACTIVE PROTEIN-HIGH SENS
$42.10EKG SUBSQ DIFF DR
$81.66INF TX HYDRATION EA ADDL HR
$77.09INF TX MED 1ST HR
$193.75LABOR PER HOUR
$31.45lactase 3000 units Tab [VDMC]
$0.71LEVEL 4
$360.62LEVEL 5
$528.50Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$33.88VENIPUNCTURE
$10.65This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Insurance Discount
-$57.50Price Negotiated by Insurer
$172.50Deductible 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.
ADM IVP TX EA ADD'L MED
$48.00CBC WITH DIFF
$60.00cefTRIAXone 500 mg Inj SDV [VDMC]
$17.90COMPREHENSIVE METABOLIC PANEL
$148.50C-REACTIVE PROTEIN-HIGH SENS
$62.25EKG SUBSQ DIFF DR
$120.75INF TX HYDRATION EA ADDL HR
$114.00INF TX MED 1ST HR
$286.50LABOR PER HOUR
$46.50lactase 3000 units Tab [VDMC]
$1.04LEVEL 4
$533.25LEVEL 5
$781.50Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$50.10VENIPUNCTURE
$15.75This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Insurance Discount
-$57.50Price Negotiated by Insurer
$172.50Deductible 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.
ADM IVP TX EA ADD'L MED
$48.00CBC WITH DIFF
$60.00cefTRIAXone 500 mg Inj SDV [VDMC]
$17.90COMPREHENSIVE METABOLIC PANEL
$148.50C-REACTIVE PROTEIN-HIGH SENS
$62.25EKG SUBSQ DIFF DR
$120.75INF TX HYDRATION EA ADDL HR
$114.00INF TX MED 1ST HR
$286.50LABOR PER HOUR
$46.50lactase 3000 units Tab [VDMC]
$1.04LEVEL 4
$533.25LEVEL 5
$781.50Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$50.10VENIPUNCTURE
$15.75This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Insurance Discount
-$23.00Price Negotiated by Insurer
$207.00Deductible 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.
ADM IVP TX EA ADD'L MED
$57.60CBC WITH DIFF
$72.00cefTRIAXone 500 mg Inj SDV [VDMC]
$21.47COMPREHENSIVE METABOLIC PANEL
$178.20C-REACTIVE PROTEIN-HIGH SENS
$74.70EKG SUBSQ DIFF DR
$144.90INF TX HYDRATION EA ADDL HR
$136.80INF TX MED 1ST HR
$343.80LABOR PER HOUR
$55.80lactase 3000 units Tab [VDMC]
$1.25LEVEL 4
$639.90LEVEL 5
$937.80Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$60.12VENIPUNCTURE
$18.90This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Insurance Discount
-$94.30Price Negotiated by Insurer
$135.70Deductible 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.
ADM IVP TX EA ADD'L MED
$37.76CBC WITH DIFF
$47.20cefTRIAXone 500 mg Inj SDV [VDMC]
$14.08COMPREHENSIVE METABOLIC PANEL
$116.82C-REACTIVE PROTEIN-HIGH SENS
$48.97EKG SUBSQ DIFF DR
$94.99INF TX HYDRATION EA ADDL HR
$89.68INF TX MED 1ST HR
$225.38LABOR PER HOUR
$36.58lactase 3000 units Tab [VDMC]
$0.82LEVEL 4
$419.49LEVEL 5
$614.78Sodium Chloride 0.9% IV Sol 50 mL [VDMC]
$39.41VENIPUNCTURE
$12.39This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Price Negotiated by Insurer
$554.90Deductible 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.
CBC WITH DIFF
$32.86COMPREHENSIVE METABOLIC PANEL
$52.08C-REACTIVE PROTEIN-HIGH SENS
$47.12EKG SUBSQ DIFF DR
$83.08INF TX HYDRATION EA ADDL HR
$553.66INF TX MED 1ST HR
$554.90LABOR PER HOUR
$2,034.84VENIPUNCTURE
$41.54This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.
Total estimated charges
$230.00Price Negotiated by Insurer
$610.39Deductible 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.
CBC WITH DIFF
$36.15COMPREHENSIVE METABOLIC PANEL
$57.29C-REACTIVE PROTEIN-HIGH SENS
$51.83EKG SUBSQ DIFF DR
$91.39INF TX HYDRATION EA ADDL HR
$609.03INF TX MED 1ST HR
$610.39LABOR PER HOUR
$2,238.32VENIPUNCTURE
$45.69This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Van Diest 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 Van Diest Medical Center directly.