CPT 73120
The standard charge for X-ray Hand, 2 Views is $768.00. 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
9440 Poppy Drive, Dallas, TX, 75218CONTACT
(214) 324-6100 Visit WebsiteChoose a plan to view the insurance rate estimate.
Total estimated charges
$768.00Insurance Discount
-$741.59Price Negotiated by Insurer
$26.41Deductible 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.
CHED 99283 - Level 3 BCE
$2,050.00CHED 99284 - Level 4 BCE
$2,350.00SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$154.00XR Finger(5th Digit) 2+ Views Right
$35.26This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$617.18Price Negotiated by Insurer
$150.82Deductible 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.
CHED 99283 - Level 3 BCE
$391.41CHED 99284 - Level 4 BCE
$607.59SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$96.64XR Finger(5th Digit) 2+ Views Right
$124.65This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$736.59Price Negotiated by Insurer
$31.41Deductible 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.
CHED 99283 - Level 3 BCE
$280.00CHED 99284 - Level 4 BCE
$280.00morphine 4 mg/mL PF IV Soln 1 mL
$11.52SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$25.20XR Finger(5th Digit) 2+ Views Right
$38.09This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$667.45Price Negotiated by Insurer
$100.55Deductible 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.
CHED 99283 - Level 3 BCE
$260.94CHED 99284 - Level 4 BCE
$405.06SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Finger(5th Digit) 2+ Views Right
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$667.45Price Negotiated by Insurer
$100.55Deductible 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.
CHED 99283 - Level 3 BCE
$260.94CHED 99284 - Level 4 BCE
$405.06SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Finger(5th Digit) 2+ Views Right
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$583.07Price Negotiated by Insurer
$184.93Deductible 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.
CHED 99283 - Level 3 BCE
$388.61CHED 99284 - Level 4 BCE
$612.11morphine 4 mg/mL PF IV Soln 1 mL
$6.76SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$105.22XR Finger(5th Digit) 2+ Views Right
$131.69This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$546.08Price Negotiated by Insurer
$221.92Deductible 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.
CHED 99283 - Level 3 BCE
$464.55CHED 99284 - Level 4 BCE
$731.72morphine 4 mg/mL PF IV Soln 1 mL
$8.11SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$125.78XR Finger(5th Digit) 2+ Views Right
$158.02This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$667.45Price Negotiated by Insurer
$100.55Deductible 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.
CHED 99283 - Level 3 BCE
$260.94CHED 99284 - Level 4 BCE
$405.06SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Finger(5th Digit) 2+ Views Right
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$520.30Price Negotiated by Insurer
$247.70Deductible 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.
CHED 99283 - Level 3 BCE
$518.15CHED 99284 - Level 4 BCE
$816.15morphine 4 mg/mL PF IV Soln 1 mL
$8.99SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$140.29XR Finger(5th Digit) 2+ Views Right
$176.38This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$92.16Price Negotiated by Insurer
$675.84Deductible 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.
CHED 99283 - Level 3 BCE
$1,367.52CHED 99284 - Level 4 BCE
$1,862.96morphine 4 mg/mL PF IV Soln 1 mL
$87.04SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$246.40XR Finger(5th Digit) 2+ Views Right
$427.68This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$540.23Price Negotiated by Insurer
$227.77Deductible 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.
CHED 99283 - Level 3 BCE
$1,039.11CHED 99284 - Level 4 BCE
$1,613.02SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$145.94XR Finger(5th Digit) 2+ Views Right
$188.25This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$736.59Price Negotiated by Insurer
$31.41Deductible 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.
SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$11.23XR Finger(5th Digit) 2+ Views Right
$38.09This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$667.45Price Negotiated by Insurer
$100.55Deductible 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.
CHED 99283 - Level 3 BCE
$260.94CHED 99284 - Level 4 BCE
$405.06SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Finger(5th Digit) 2+ Views Right
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$667.45Price Negotiated by Insurer
$100.55Deductible 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.
CHED 99283 - Level 3 BCE
$260.94CHED 99284 - Level 4 BCE
$405.06SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Finger(5th Digit) 2+ Views Right
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$667.45Price Negotiated by Insurer
$100.55Deductible 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.
CHED 99283 - Level 3 BCE
$260.94CHED 99284 - Level 4 BCE
$405.06SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Finger(5th Digit) 2+ Views Right
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$736.59Price Negotiated by Insurer
$31.41Deductible 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.
SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$11.23XR Finger(5th Digit) 2+ Views Right
$38.09This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$667.45Price Negotiated by Insurer
$100.55Deductible 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.
CHED 99283 - Level 3 BCE
$260.94CHED 99284 - Level 4 BCE
$405.06SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Finger(5th Digit) 2+ Views Right
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$667.45Price Negotiated by Insurer
$100.55Deductible 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.
CHED 99283 - Level 3 BCE
$260.94CHED 99284 - Level 4 BCE
$405.06SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Finger(5th Digit) 2+ Views Right
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$268.80Price Negotiated by Insurer
$499.20Deductible 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.
CHED 99283 - Level 3 BCE
$1,010.10CHED 99284 - Level 4 BCE
$1,376.05morphine 4 mg/mL PF IV Soln 1 mL
$83.20SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$182.00XR Finger(5th Digit) 2+ Views Right
$315.90This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$268.80Price Negotiated by Insurer
$499.20Deductible 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.
CHED 99283 - Level 3 BCE
$1,010.10CHED 99284 - Level 4 BCE
$1,376.05morphine 4 mg/mL PF IV Soln 1 mL
$83.20SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$182.00XR Finger(5th Digit) 2+ Views Right
$315.90This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$268.80Price Negotiated by Insurer
$499.20Deductible 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.
CHED 99283 - Level 3 BCE
$1,010.10CHED 99284 - Level 4 BCE
$1,376.05morphine 4 mg/mL PF IV Soln 1 mL
$83.20SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$182.00XR Finger(5th Digit) 2+ Views Right
$315.90This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$736.59Price Negotiated by Insurer
$31.41Deductible 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.
SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$11.23XR Finger(5th Digit) 2+ Views Right
$38.09This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$766.20Price Negotiated by Insurer
$1.80Deductible 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.
CHED 99283 - Level 3 BCE
$4.67CHED 99284 - Level 4 BCE
$7.24morphine 4 mg/mL PF IV Soln 1 mL
$64.00SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$1.15XR Finger(5th Digit) 2+ Views Right
$1.49This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$667.45Price Negotiated by Insurer
$100.55Deductible 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.
CHED 99283 - Level 3 BCE
$260.94CHED 99284 - Level 4 BCE
$405.06SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Finger(5th Digit) 2+ Views Right
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$736.59Price Negotiated by Insurer
$31.41Deductible 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.
SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$11.23XR Finger(5th Digit) 2+ Views Right
$38.09This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$667.45Price Negotiated by Insurer
$100.55Deductible 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.
CHED 99283 - Level 3 BCE
$260.94CHED 99284 - Level 4 BCE
$405.06morphine 4 mg/mL PF IV Soln 1 mL
$17.41SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Finger(5th Digit) 2+ Views Right
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$667.45Price Negotiated by Insurer
$100.55Deductible 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.
CHED 99283 - Level 3 BCE
$260.94CHED 99284 - Level 4 BCE
$405.06SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Finger(5th Digit) 2+ Views Right
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$667.45Price Negotiated by Insurer
$100.55Deductible 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.
CHED 99283 - Level 3 BCE
$260.94CHED 99284 - Level 4 BCE
$405.06SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Finger(5th Digit) 2+ Views Right
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$667.45Price Negotiated by Insurer
$100.55Deductible 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.
CHED 99283 - Level 3 BCE
$260.94CHED 99284 - Level 4 BCE
$405.06SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Finger(5th Digit) 2+ Views Right
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$667.45Price Negotiated by Insurer
$100.55Deductible 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.
CHED 99283 - Level 3 BCE
$260.94CHED 99284 - Level 4 BCE
$405.06SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Finger(5th Digit) 2+ Views Right
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$768.00Insurance Discount
-$667.45Price Negotiated by Insurer
$100.55Deductible 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.
CHED 99283 - Level 3 BCE
$260.94CHED 99284 - Level 4 BCE
$405.06SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Finger(5th Digit) 2+ Views Right
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock 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 White Rock Medical Center directly at (214) 324-6100.