CPT J3475
The standard charge for Injection, magnesium sulfate, per 500 mg is $24.20. 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
$24.20Insurance Discount
-$2.42Price Negotiated by Insurer
$21.78Deductible 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.
Bill Venipuncture
$18.90CBC WITH DIFF
$72.00Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$66.96INF TX MED SCHED 1ST HR
$343.80INFUSION TX MED EA ADDL HOUR
$144.90zonisamide 50 mg Cap [VDMC]
$1.30This 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
$24.20Insurance Discount
-$2.42Price Negotiated by Insurer
$21.78Deductible 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.
Bill Venipuncture
$18.90CBC WITH DIFF
$72.00Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$66.96INF TX MED SCHED 1ST HR
$343.80INFUSION TX MED EA ADDL HOUR
$144.90zonisamide 50 mg Cap [VDMC]
$1.30This 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
$24.20Insurance Discount
-$10.41Price Negotiated by Insurer
$13.79Deductible 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.
Bill Venipuncture
$11.97CBC WITH DIFF
$45.60Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$42.41INF TX MED SCHED 1ST HR
$217.74INFUSION TX MED EA ADDL HOUR
$91.77zonisamide 50 mg Cap [VDMC]
$0.83This 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
$24.20Insurance Discount
-$10.24Price Negotiated by Insurer
$13.96Deductible 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.
Bill Venipuncture
$12.11CBC WITH DIFF
$46.14Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$42.91INF TX MED SCHED 1ST HR
$220.34INFUSION TX MED EA ADDL HOUR
$92.86zonisamide 50 mg Cap [VDMC]
$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 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
$24.20Insurance Discount
-$13.20Price Negotiated by Insurer
$11.00Deductible 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.
Bill Venipuncture
$9.54CBC WITH DIFF
$36.36Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$33.81INF TX MED SCHED 1ST HR
$173.62INFUSION TX MED EA ADDL HOUR
$73.17zonisamide 50 mg Cap [VDMC]
$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 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
$24.20Insurance Discount
-$4.84Price Negotiated by Insurer
$19.36Deductible 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.
Bill Venipuncture
$16.80CBC WITH DIFF
$64.00Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$59.52INF TX MED SCHED 1ST HR
$305.60INFUSION TX MED EA ADDL HOUR
$128.80zonisamide 50 mg Cap [VDMC]
$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 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
$24.20Insurance Discount
-$6.05Price Negotiated by Insurer
$18.15Deductible 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.
Bill Venipuncture
$15.75CBC WITH DIFF
$60.00Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$55.80INF TX MED SCHED 1ST HR
$286.50INFUSION TX MED EA ADDL HOUR
$120.75zonisamide 50 mg Cap [VDMC]
$1.09This 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
$24.20Insurance Discount
-$13.31Price Negotiated by Insurer
$10.89Deductible 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.
Bill Venipuncture
$9.45CBC WITH DIFF
$36.00Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$33.48INF TX MED SCHED 1ST HR
$171.90INFUSION TX MED EA ADDL HOUR
$72.45zonisamide 50 mg Cap [VDMC]
$0.65This 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
$24.20Insurance Discount
-$10.38Price Negotiated by Insurer
$13.82Deductible 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.
Bill Venipuncture
$12.00CBC WITH DIFF
$45.70Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$42.50INF TX MED SCHED 1ST HR
$218.20INFUSION TX MED EA ADDL HOUR
$91.96zonisamide 50 mg Cap [VDMC]
$0.83This 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
$24.20Insurance Discount
-$6.05Price Negotiated by Insurer
$18.15Deductible 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.
Bill Venipuncture
$15.75CBC WITH DIFF
$60.00Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$55.80INF TX MED SCHED 1ST HR
$286.50INFUSION TX MED EA ADDL HOUR
$120.75zonisamide 50 mg Cap [VDMC]
$1.09This 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
$24.20Insurance Discount
-$13.31Price Negotiated by Insurer
$10.89Deductible 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.
Bill Venipuncture
$9.45CBC WITH DIFF
$36.00Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$33.48INF TX MED SCHED 1ST HR
$171.90INFUSION TX MED EA ADDL HOUR
$72.45zonisamide 50 mg Cap [VDMC]
$0.65This 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
$24.20Insurance Discount
-$7.26Price Negotiated by Insurer
$16.94Deductible 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.
Bill Venipuncture
$14.70CBC WITH DIFF
$56.00Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$52.08INF TX MED SCHED 1ST HR
$267.40INFUSION TX MED EA ADDL HOUR
$112.70zonisamide 50 mg Cap [VDMC]
$1.02This 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
$24.20Insurance Discount
-$10.18Price Negotiated by Insurer
$14.02Deductible 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.
Bill Venipuncture
$12.17CBC WITH DIFF
$46.37Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$43.12INF TX MED SCHED 1ST HR
$221.41INFUSION TX MED EA ADDL HOUR
$93.32zonisamide 50 mg Cap [VDMC]
$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 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
$24.20Insurance Discount
-$11.68Price Negotiated by Insurer
$12.52Deductible 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.
Bill Venipuncture
$10.87CBC WITH DIFF
$41.40Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$38.50INF TX MED SCHED 1ST HR
$197.68INFUSION TX MED EA ADDL HOUR
$83.32zonisamide 50 mg Cap [VDMC]
$0.75This 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
$24.20Insurance Discount
-$2.42Price Negotiated by Insurer
$21.78Deductible 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.
Bill Venipuncture
$18.90CBC WITH DIFF
$72.00Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$66.96INF TX MED SCHED 1ST HR
$343.80INFUSION TX MED EA ADDL HOUR
$144.90zonisamide 50 mg Cap [VDMC]
$1.30This 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
$24.20Insurance Discount
-$9.92Price Negotiated by Insurer
$14.28Deductible 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.
Bill Venipuncture
$12.39CBC WITH DIFF
$47.20Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$43.90INF TX MED SCHED 1ST HR
$225.38INFUSION TX MED EA ADDL HOUR
$94.99zonisamide 50 mg Cap [VDMC]
$0.86This 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
$24.20Price Negotiated by Insurer
$201.36Deductible 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.
Bill Venipuncture
$12.05CBC WITH DIFF
$29.07Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$201.36INF TX MED SCHED 1ST HR
$543.09INFUSION TX MED EA ADDL HOUR
$626.76This 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
$24.20Price Negotiated by Insurer
$221.80Deductible 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.
Bill Venipuncture
$13.28CBC WITH DIFF
$32.02Dextrose 5% in Water IV Sol 1000 mL [VDMC]
$221.80INF TX MED SCHED 1ST HR
$598.25INFUSION TX MED EA ADDL HOUR
$690.40This 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.