CPT 73020

X-ray shoulder, 1 view

The standard charge for X-ray shoulder, 1 view is $507.00. 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:

  • Your Summary of Benefits and Coverage statement from your health insurance plan. If you don't have a paper copy, this is often also available online through your health insurance company's website.
  • Your remaining deductible amount for this year for your insurance plan. Many insurance plans require you to pay a certain amount out of pocket before the insurance kicks in. This amount is called the deductible and is different for each insurance plan.

More Information

White Rock Medical Center

Cost Estimate

Choose a plan to view the insurance rate estimate.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$491.00

  • Price Negotiated by Insurer

    $16.00

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $15.30

  • Blood Culture

    $10.83

  • CBC w/ Diff

    $8.16

  • CHED 99285 - Level 5 BCE

    $2,500.00

  • CHED Arterial Line Activity Blood Drawn BCE

    $56.10

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $212.04

  • Comprehensive Metabolic Panel

    $11.10

  • Creatine Kinase

    $6.84

  • ED - Initial Admin Charge 90471

    $68.20

  • Lactic Acid Level

    $12.14

  • Lipase Level

    $7.23

  • Minimum Inhibitory Concentration

    $9.08

  • NT-proBNP SO

    $41.23

  • ROOM/BED: Observation

    $4,120.00

  • RT EKG 12 Lead Tracing BCE

    $10.11

  • Salicylate Level

    $65.24

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $138.05

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $198.00

  • tetanus-diptheria toxoid 0.5 ml injection

    $70.40

  • Troponin-I

    $13.09

  • Urinalysis Microscopic

    $3.32

  • Urine Culture

    $8.49

  • XR Chest Abdomen Infant

    $19.46

  • XR Hip 2-3 Views Right BCE

    $41.42

  • XR Wrist 2 Views Right BCE

    $29.49

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$382.35

  • Price Negotiated by Insurer

    $124.65

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $21.86

  • Blood Culture

    $15.48

  • CBC w/ Diff

    $11.66

  • CHED 99285 - Level 5 BCE

    $881.13

  • CHED Arterial Line Activity Blood Drawn BCE

    $175.23

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $292.59

  • Comprehensive Metabolic Panel

    $15.84

  • Creatine Kinase

    $9.76

  • ED - Initial Admin Charge 90471

    $96.64

  • Lactic Acid Level

    $17.36

  • Lipase Level

    $10.34

  • Minimum Inhibitory Concentration

    $12.98

  • NT-proBNP SO

    $58.89

  • RT EKG 12 Lead Tracing BCE

    $83.91

  • Salicylate Level

    $93.21

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $65.16

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $294.03

  • Troponin-I

    $18.70

  • Urinalysis Microscopic

    $4.76

  • Urine Culture

    $12.14

  • XR Chest Abdomen Infant

    $124.65

  • XR Hip 2-3 Views Right BCE

    $124.65

  • XR Wrist 2 Views Right BCE

    $124.65

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$485.29

  • Price Negotiated by Insurer

    $21.71

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $5.68

  • Blood Culture

    $4.02

  • budesonide 0.5 mg/2 mL Inh Susp 2 mL

    $2.05

  • CBC w/ Diff

    $3.03

  • cefTRIAXone 1 g and NS; 50 mL connect

    $11.54

  • CHED 99285 - Level 5 BCE

    $280.00

  • CHED Arterial Line Activity Blood Drawn BCE

    $9.18

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $34.70

  • Comprehensive Metabolic Panel

    $4.12

  • Creatine Kinase

    $2.54

  • ED - Initial Admin Charge 90471

    $11.16

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $11.54

  • ketorolac 30 mg/mL Inj Soln 1 mL

    $11.54

  • Lactic Acid Level

    $4.51

  • Lipase Level

    $2.69

  • Minimum Inhibitory Concentration

    $3.37

  • morphine 4 mg/mL PF IV Soln 1 mL

    $11.52

  • NT-proBNP SO

    $15.31

  • ondansetron 2 mg/mL Inj Soln 2 mL

    $11.52

  • oxyCODONE 10 mg ER Tab

    $0.72

  • ROOM/BED: Observation

    $400.00

  • RT EKG 12 Lead Tracing BCE

    $63.00

  • Salicylate Level

    $24.23

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $22.59

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $32.40

  • tetanus-diptheria toxoid 0.5 ml injection

    $11.52

  • Troponin-I

    $4.86

  • Urinalysis Microscopic

    $1.24

  • Urine Culture

    $3.16

  • XR Chest Abdomen Infant

    $26.06

  • XR Hip 2-3 Views Right BCE

    $47.11

  • XR Wrist 2 Views Right BCE

    $34.09

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$423.90

  • Price Negotiated by Insurer

    $83.10

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • CHED 99285 - Level 5 BCE

    $587.42

  • CHED Arterial Line Activity Blood Drawn BCE

    $116.82

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $195.06

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • ED - Initial Admin Charge 90471

    $64.43

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • RT EKG 12 Lead Tracing BCE

    $55.94

  • Salicylate Level

    $62.14

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $43.44

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $196.02

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $83.10

  • XR Hip 2-3 Views Right BCE

    $83.10

  • XR Wrist 2 Views Right BCE

    $83.10

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$423.90

  • Price Negotiated by Insurer

    $83.10

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • CHED 99285 - Level 5 BCE

    $587.42

  • CHED Arterial Line Activity Blood Drawn BCE

    $116.82

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $195.06

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • ED - Initial Admin Charge 90471

    $64.43

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • RT EKG 12 Lead Tracing BCE

    $55.94

  • Salicylate Level

    $62.14

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $43.44

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $196.02

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $83.10

  • XR Hip 2-3 Views Right BCE

    $83.10

  • XR Wrist 2 Views Right BCE

    $83.10

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$375.31

  • Price Negotiated by Insurer

    $131.69

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $24.04

  • Blood Culture

    $17.03

  • budesonide 0.5 mg/2 mL Inh Susp 2 mL

    $6.84

  • CBC w/ Diff

    $12.82

  • cefTRIAXone 1 g and NS; 50 mL connect

    $3.67

  • CHED 99285 - Level 5 BCE

    $877.85

  • CHED Arterial Line Activity Blood Drawn BCE

    $182.08

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $320.09

  • Comprehensive Metabolic Panel

    $17.42

  • Creatine Kinase

    $10.74

  • ED - Initial Admin Charge 90471

    $105.22

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $1.77

  • ketorolac 30 mg/mL Inj Soln 1 mL

    $0.26

  • Lactic Acid Level

    $19.09

  • Lipase Level

    $11.37

  • Minimum Inhibitory Concentration

    $14.27

  • morphine 4 mg/mL PF IV Soln 1 mL

    $6.76

  • NT-proBNP SO

    $64.78

  • ondansetron 2 mg/mL Inj Soln 2 mL

    $0.86

  • oxyCODONE 10 mg ER Tab

    $2.40

  • ROOM/BED: Observation

    $221.36

  • RT EKG 12 Lead Tracing BCE

    $95.72

  • Salicylate Level

    $102.53

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $23.82

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $68.97

  • tetanus-diptheria toxoid 0.5 ml injection

    $57.30

  • Troponin-I

    $20.58

  • Urinalysis Microscopic

    $5.23

  • Urine Culture

    $13.35

  • XR Chest Abdomen Infant

    $131.69

  • XR Hip 2-3 Views Right BCE

    $131.69

  • XR Wrist 2 Views Right BCE

    $131.69

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$348.98

  • Price Negotiated by Insurer

    $158.02

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $28.85

  • Blood Culture

    $20.43

  • budesonide 0.5 mg/2 mL Inh Susp 2 mL

    $8.21

  • CBC w/ Diff

    $15.38

  • cefTRIAXone 1 g and NS; 50 mL connect

    $4.40

  • CHED 99285 - Level 5 BCE

    $1,049.38

  • CHED Arterial Line Activity Blood Drawn BCE

    $218.06

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $382.64

  • Comprehensive Metabolic Panel

    $20.91

  • Creatine Kinase

    $12.89

  • ED - Initial Admin Charge 90471

    $125.78

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $2.12

  • ketorolac 30 mg/mL Inj Soln 1 mL

    $0.31

  • Lactic Acid Level

    $22.91

  • Lipase Level

    $13.64

  • Minimum Inhibitory Concentration

    $17.13

  • morphine 4 mg/mL PF IV Soln 1 mL

    $8.11

  • NT-proBNP SO

    $77.73

  • ondansetron 2 mg/mL Inj Soln 2 mL

    $1.03

  • oxyCODONE 10 mg ER Tab

    $2.88

  • ROOM/BED: Observation

    $264.62

  • RT EKG 12 Lead Tracing BCE

    $114.42

  • Salicylate Level

    $123.04

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $28.48

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $82.45

  • tetanus-diptheria toxoid 0.5 ml injection

    $68.76

  • Troponin-I

    $24.69

  • Urinalysis Microscopic

    $6.28

  • Urine Culture

    $16.02

  • XR Chest Abdomen Infant

    $158.02

  • XR Hip 2-3 Views Right BCE

    $158.02

  • XR Wrist 2 Views Right BCE

    $158.02

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$423.90

  • Price Negotiated by Insurer

    $83.10

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • CHED 99285 - Level 5 BCE

    $587.42

  • CHED Arterial Line Activity Blood Drawn BCE

    $116.82

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $195.06

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • ED - Initial Admin Charge 90471

    $64.43

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • RT EKG 12 Lead Tracing BCE

    $55.94

  • Salicylate Level

    $62.14

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $43.44

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $196.02

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $83.10

  • XR Hip 2-3 Views Right BCE

    $83.10

  • XR Wrist 2 Views Right BCE

    $83.10

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$330.62

  • Price Negotiated by Insurer

    $176.38

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $32.20

  • Blood Culture

    $22.81

  • budesonide 0.5 mg/2 mL Inh Susp 2 mL

    $9.12

  • CBC w/ Diff

    $17.17

  • cefTRIAXone 1 g and NS; 50 mL connect

    $4.88

  • CHED 99285 - Level 5 BCE

    $1,170.46

  • CHED Arterial Line Activity Blood Drawn BCE

    $274.76

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $426.79

  • Comprehensive Metabolic Panel

    $23.34

  • Creatine Kinase

    $14.39

  • ED - Initial Admin Charge 90471

    $140.29

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $2.35

  • ketorolac 30 mg/mL Inj Soln 1 mL

    $0.35

  • Lactic Acid Level

    $25.57

  • Lipase Level

    $15.23

  • Minimum Inhibitory Concentration

    $19.12

  • morphine 4 mg/mL PF IV Soln 1 mL

    $8.99

  • NT-proBNP SO

    $86.76

  • ondansetron 2 mg/mL Inj Soln 2 mL

    $1.14

  • oxyCODONE 10 mg ER Tab

    $3.20

  • ROOM/BED: Observation

    $295.15

  • RT EKG 12 Lead Tracing BCE

    $127.62

  • Salicylate Level

    $137.33

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $31.76

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $91.96

  • tetanus-diptheria toxoid 0.5 ml injection

    $76.27

  • Troponin-I

    $27.56

  • Urinalysis Microscopic

    $7.01

  • Urine Culture

    $17.88

  • XR Chest Abdomen Infant

    $176.38

  • XR Hip 2-3 Views Right BCE

    $176.38

  • XR Wrist 2 Views Right BCE

    $176.38

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$60.84

  • Price Negotiated by Insurer

    $446.16

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $278.08

  • Blood Culture

    $344.08

  • budesonide 0.5 mg/2 mL Inh Susp 2 mL

    $15.50

  • CBC w/ Diff

    $164.56

  • cefTRIAXone 1 g and NS; 50 mL connect

    $87.16

  • CHED 99285 - Level 5 BCE

    $2,675.20

  • CHED Arterial Line Activity Blood Drawn BCE

    $89.76

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $339.27

  • Comprehensive Metabolic Panel

    $581.68

  • Creatine Kinase

    $243.76

  • ED - Initial Admin Charge 90471

    $109.12

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $87.16

  • ketorolac 30 mg/mL Inj Soln 1 mL

    $87.16

  • Lactic Acid Level

    $237.60

  • Lipase Level

    $241.12

  • Minimum Inhibitory Concentration

    $220.88

  • morphine 4 mg/mL PF IV Soln 1 mL

    $87.04

  • NT-proBNP SO

    $439.12

  • ondansetron 2 mg/mL Inj Soln 2 mL

    $87.04

  • oxyCODONE 10 mg ER Tab

    $5.44

  • ROOM/BED: Observation

    $96.80

  • RT EKG 12 Lead Tracing BCE

    $616.00

  • Salicylate Level

    $278.96

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $220.88

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $316.80

  • tetanus-diptheria toxoid 0.5 ml injection

    $87.04

  • Troponin-I

    $388.96

  • Urinalysis Microscopic

    $165.44

  • Urine Culture

    $124.08

  • XR Chest Abdomen Infant

    $584.32

  • XR Hip 2-3 Views Right BCE

    $543.84

  • XR Wrist 2 Views Right BCE

    $409.20

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$318.75

  • Price Negotiated by Insurer

    $188.25

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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 99285 - Level 5 BCE

    $3,123.61

  • CHED Arterial Line Activity Blood Drawn BCE

    $264.63

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $441.88

  • ED - Initial Admin Charge 90471

    $145.94

  • RT EKG 12 Lead Tracing BCE

    $126.71

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $98.40

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $444.05

  • XR Chest Abdomen Infant

    $188.25

  • XR Hip 2-3 Views Right BCE

    $188.25

  • XR Wrist 2 Views Right BCE

    $188.25

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$485.29

  • Price Negotiated by Insurer

    $21.71

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • Salicylate Level

    $62.14

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $20.85

  • XR Hip 2-3 Views Right BCE

    $47.11

  • XR Wrist 2 Views Right BCE

    $34.09

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$423.90

  • Price Negotiated by Insurer

    $83.10

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • CHED 99285 - Level 5 BCE

    $587.42

  • CHED Arterial Line Activity Blood Drawn BCE

    $116.82

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $195.06

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • ED - Initial Admin Charge 90471

    $64.43

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • RT EKG 12 Lead Tracing BCE

    $55.94

  • Salicylate Level

    $62.14

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $43.44

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $196.02

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $83.10

  • XR Hip 2-3 Views Right BCE

    $83.10

  • XR Wrist 2 Views Right BCE

    $83.10

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$423.90

  • Price Negotiated by Insurer

    $83.10

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • CHED 99285 - Level 5 BCE

    $587.42

  • CHED Arterial Line Activity Blood Drawn BCE

    $116.82

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $195.06

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • ED - Initial Admin Charge 90471

    $64.43

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • RT EKG 12 Lead Tracing BCE

    $55.94

  • Salicylate Level

    $62.14

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $43.44

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $196.02

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $83.10

  • XR Hip 2-3 Views Right BCE

    $83.10

  • XR Wrist 2 Views Right BCE

    $83.10

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$423.90

  • Price Negotiated by Insurer

    $83.10

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • CHED 99285 - Level 5 BCE

    $587.42

  • CHED Arterial Line Activity Blood Drawn BCE

    $116.82

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $195.06

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • ED - Initial Admin Charge 90471

    $64.43

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • RT EKG 12 Lead Tracing BCE

    $55.94

  • Salicylate Level

    $62.14

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $43.44

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $196.02

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $83.10

  • XR Hip 2-3 Views Right BCE

    $83.10

  • XR Wrist 2 Views Right BCE

    $83.10

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$485.29

  • Price Negotiated by Insurer

    $21.71

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • Salicylate Level

    $62.14

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $20.85

  • XR Hip 2-3 Views Right BCE

    $47.11

  • XR Wrist 2 Views Right BCE

    $34.09

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$423.90

  • Price Negotiated by Insurer

    $83.10

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • CHED 99285 - Level 5 BCE

    $587.42

  • CHED Arterial Line Activity Blood Drawn BCE

    $116.82

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $195.06

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • ED - Initial Admin Charge 90471

    $64.43

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • RT EKG 12 Lead Tracing BCE

    $55.94

  • Salicylate Level

    $62.14

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $43.44

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $196.02

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $83.10

  • XR Hip 2-3 Views Right BCE

    $83.10

  • XR Wrist 2 Views Right BCE

    $83.10

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$423.90

  • Price Negotiated by Insurer

    $83.10

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • CHED 99285 - Level 5 BCE

    $587.42

  • CHED Arterial Line Activity Blood Drawn BCE

    $116.82

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $195.06

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • ED - Initial Admin Charge 90471

    $64.43

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • RT EKG 12 Lead Tracing BCE

    $55.94

  • Salicylate Level

    $62.14

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $43.44

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $196.02

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $83.10

  • XR Hip 2-3 Views Right BCE

    $83.10

  • XR Wrist 2 Views Right BCE

    $83.10

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$177.45

  • Price Negotiated by Insurer

    $329.55

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $205.40

  • Blood Culture

    $254.15

  • budesonide 0.5 mg/2 mL Inh Susp 2 mL

    $14.82

  • CBC w/ Diff

    $121.55

  • cefTRIAXone 1 g and NS; 50 mL connect

    $83.31

  • CHED 99285 - Level 5 BCE

    $1,976.00

  • CHED Arterial Line Activity Blood Drawn BCE

    $66.30

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $250.59

  • Comprehensive Metabolic Panel

    $429.65

  • Creatine Kinase

    $180.05

  • ED - Initial Admin Charge 90471

    $80.60

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $83.31

  • ketorolac 30 mg/mL Inj Soln 1 mL

    $83.31

  • Lactic Acid Level

    $175.50

  • Lipase Level

    $178.10

  • Minimum Inhibitory Concentration

    $163.15

  • morphine 4 mg/mL PF IV Soln 1 mL

    $83.20

  • NT-proBNP SO

    $324.35

  • ondansetron 2 mg/mL Inj Soln 2 mL

    $83.20

  • oxyCODONE 10 mg ER Tab

    $5.20

  • ROOM/BED: Observation

    $71.50

  • RT EKG 12 Lead Tracing BCE

    $455.00

  • Salicylate Level

    $206.05

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $163.15

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $234.00

  • tetanus-diptheria toxoid 0.5 ml injection

    $83.20

  • Troponin-I

    $287.30

  • Urinalysis Microscopic

    $122.20

  • Urine Culture

    $91.65

  • XR Chest Abdomen Infant

    $431.60

  • XR Hip 2-3 Views Right BCE

    $401.70

  • XR Wrist 2 Views Right BCE

    $302.25

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$177.45

  • Price Negotiated by Insurer

    $329.55

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $205.40

  • Blood Culture

    $254.15

  • budesonide 0.5 mg/2 mL Inh Susp 2 mL

    $14.82

  • CBC w/ Diff

    $121.55

  • cefTRIAXone 1 g and NS; 50 mL connect

    $83.31

  • CHED 99285 - Level 5 BCE

    $1,976.00

  • CHED Arterial Line Activity Blood Drawn BCE

    $66.30

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $250.59

  • Comprehensive Metabolic Panel

    $429.65

  • Creatine Kinase

    $180.05

  • ED - Initial Admin Charge 90471

    $80.60

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $83.31

  • ketorolac 30 mg/mL Inj Soln 1 mL

    $83.31

  • Lactic Acid Level

    $175.50

  • Lipase Level

    $178.10

  • Minimum Inhibitory Concentration

    $163.15

  • morphine 4 mg/mL PF IV Soln 1 mL

    $83.20

  • NT-proBNP SO

    $324.35

  • ondansetron 2 mg/mL Inj Soln 2 mL

    $83.20

  • oxyCODONE 10 mg ER Tab

    $5.20

  • ROOM/BED: Observation

    $71.50

  • RT EKG 12 Lead Tracing BCE

    $455.00

  • Salicylate Level

    $206.05

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $163.15

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $234.00

  • tetanus-diptheria toxoid 0.5 ml injection

    $83.20

  • Troponin-I

    $287.30

  • Urinalysis Microscopic

    $122.20

  • Urine Culture

    $91.65

  • XR Chest Abdomen Infant

    $431.60

  • XR Hip 2-3 Views Right BCE

    $401.70

  • XR Wrist 2 Views Right BCE

    $302.25

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$177.45

  • Price Negotiated by Insurer

    $329.55

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $205.40

  • Blood Culture

    $254.15

  • budesonide 0.5 mg/2 mL Inh Susp 2 mL

    $14.82

  • CBC w/ Diff

    $121.55

  • cefTRIAXone 1 g and NS; 50 mL connect

    $83.31

  • CHED 99285 - Level 5 BCE

    $1,976.00

  • CHED Arterial Line Activity Blood Drawn BCE

    $66.30

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $250.59

  • Comprehensive Metabolic Panel

    $429.65

  • Creatine Kinase

    $180.05

  • ED - Initial Admin Charge 90471

    $80.60

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $83.31

  • ketorolac 30 mg/mL Inj Soln 1 mL

    $83.31

  • Lactic Acid Level

    $175.50

  • Lipase Level

    $178.10

  • Minimum Inhibitory Concentration

    $163.15

  • morphine 4 mg/mL PF IV Soln 1 mL

    $83.20

  • NT-proBNP SO

    $324.35

  • ondansetron 2 mg/mL Inj Soln 2 mL

    $83.20

  • oxyCODONE 10 mg ER Tab

    $5.20

  • ROOM/BED: Observation

    $71.50

  • RT EKG 12 Lead Tracing BCE

    $455.00

  • Salicylate Level

    $206.05

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $163.15

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $234.00

  • tetanus-diptheria toxoid 0.5 ml injection

    $83.20

  • Troponin-I

    $287.30

  • Urinalysis Microscopic

    $122.20

  • Urine Culture

    $91.65

  • XR Chest Abdomen Infant

    $431.60

  • XR Hip 2-3 Views Right BCE

    $401.70

  • XR Wrist 2 Views Right BCE

    $302.25

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$485.29

  • Price Negotiated by Insurer

    $21.71

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • Salicylate Level

    $62.14

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $20.85

  • XR Hip 2-3 Views Right BCE

    $47.11

  • XR Wrist 2 Views Right BCE

    $34.09

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$505.51

  • Price Negotiated by Insurer

    $1.49

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $18.21

  • Blood Culture

    $12.90

  • budesonide 0.5 mg/2 mL Inh Susp 2 mL

    $11.40

  • CBC w/ Diff

    $9.71

  • cefTRIAXone 1 g and NS; 50 mL connect

    $64.08

  • CHED 99285 - Level 5 BCE

    $10.51

  • CHED Arterial Line Activity Blood Drawn BCE

    $2.09

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $3.49

  • Comprehensive Metabolic Panel

    $13.20

  • Creatine Kinase

    $8.14

  • ED - Initial Admin Charge 90471

    $1.15

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $64.08

  • ketorolac 30 mg/mL Inj Soln 1 mL

    $64.08

  • Lactic Acid Level

    $14.46

  • Lipase Level

    $8.61

  • Minimum Inhibitory Concentration

    $10.81

  • morphine 4 mg/mL PF IV Soln 1 mL

    $64.00

  • NT-proBNP SO

    $49.08

  • ondansetron 2 mg/mL Inj Soln 2 mL

    $64.00

  • oxyCODONE 10 mg ER Tab

    $4.00

  • ROOM/BED: Observation

    $55.00

  • RT EKG 12 Lead Tracing BCE

    $1.00

  • Salicylate Level

    $77.68

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $0.78

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $3.51

  • tetanus-diptheria toxoid 0.5 ml injection

    $64.00

  • Troponin-I

    $15.59

  • Urinalysis Microscopic

    $3.96

  • Urine Culture

    $10.11

  • XR Chest Abdomen Infant

    $1.49

  • XR Hip 2-3 Views Right BCE

    $1.49

  • XR Wrist 2 Views Right BCE

    $1.49

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$423.90

  • Price Negotiated by Insurer

    $83.10

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • CHED 99285 - Level 5 BCE

    $587.42

  • CHED Arterial Line Activity Blood Drawn BCE

    $116.82

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $195.06

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • ED - Initial Admin Charge 90471

    $64.43

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • RT EKG 12 Lead Tracing BCE

    $55.94

  • Salicylate Level

    $62.14

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $43.44

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $196.02

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $83.10

  • XR Hip 2-3 Views Right BCE

    $83.10

  • XR Wrist 2 Views Right BCE

    $83.10

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$485.29

  • Price Negotiated by Insurer

    $21.71

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • Salicylate Level

    $62.14

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $20.85

  • XR Hip 2-3 Views Right BCE

    $47.11

  • XR Wrist 2 Views Right BCE

    $34.09

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$423.90

  • Price Negotiated by Insurer

    $83.10

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • budesonide 0.5 mg/2 mL Inh Susp 2 mL

    $3.10

  • CBC w/ Diff

    $7.77

  • cefTRIAXone 1 g and NS; 50 mL connect

    $17.43

  • CHED 99285 - Level 5 BCE

    $587.42

  • CHED Arterial Line Activity Blood Drawn BCE

    $116.82

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $195.06

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • ED - Initial Admin Charge 90471

    $64.43

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $17.43

  • ketorolac 30 mg/mL Inj Soln 1 mL

    $17.43

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • morphine 4 mg/mL PF IV Soln 1 mL

    $17.41

  • NT-proBNP SO

    $39.26

  • ondansetron 2 mg/mL Inj Soln 2 mL

    $17.41

  • oxyCODONE 10 mg ER Tab

    $1.09

  • ROOM/BED: Observation

    $14.96

  • RT EKG 12 Lead Tracing BCE

    $55.94

  • Salicylate Level

    $62.14

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $43.44

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $196.02

  • tetanus-diptheria toxoid 0.5 ml injection

    $17.41

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $83.10

  • XR Hip 2-3 Views Right BCE

    $83.10

  • XR Wrist 2 Views Right BCE

    $83.10

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$423.90

  • Price Negotiated by Insurer

    $83.10

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • CHED 99285 - Level 5 BCE

    $587.42

  • CHED Arterial Line Activity Blood Drawn BCE

    $116.82

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $195.06

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • ED - Initial Admin Charge 90471

    $64.43

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • RT EKG 12 Lead Tracing BCE

    $55.94

  • Salicylate Level

    $62.14

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $43.44

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $196.02

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $83.10

  • XR Hip 2-3 Views Right BCE

    $83.10

  • XR Wrist 2 Views Right BCE

    $83.10

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$423.90

  • Price Negotiated by Insurer

    $83.10

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • CHED 99285 - Level 5 BCE

    $587.42

  • CHED Arterial Line Activity Blood Drawn BCE

    $116.82

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $195.06

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • ED - Initial Admin Charge 90471

    $64.43

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • RT EKG 12 Lead Tracing BCE

    $55.94

  • Salicylate Level

    $62.14

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $43.44

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $196.02

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $83.10

  • XR Hip 2-3 Views Right BCE

    $83.10

  • XR Wrist 2 Views Right BCE

    $83.10

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$423.90

  • Price Negotiated by Insurer

    $83.10

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • CHED 99285 - Level 5 BCE

    $587.42

  • CHED Arterial Line Activity Blood Drawn BCE

    $116.82

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $195.06

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • ED - Initial Admin Charge 90471

    $43.44

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • RT EKG 12 Lead Tracing BCE

    $55.94

  • Salicylate Level

    $62.14

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $43.44

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $196.02

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $83.10

  • XR Hip 2-3 Views Right BCE

    $83.10

  • XR Wrist 2 Views Right BCE

    $83.10

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$423.90

  • Price Negotiated by Insurer

    $83.10

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • CHED 99285 - Level 5 BCE

    $587.42

  • CHED Arterial Line Activity Blood Drawn BCE

    $116.82

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $195.06

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • ED - Initial Admin Charge 90471

    $64.43

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • RT EKG 12 Lead Tracing BCE

    $55.94

  • Salicylate Level

    $62.14

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $43.44

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $196.02

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $83.10

  • XR Hip 2-3 Views Right BCE

    $83.10

  • XR Wrist 2 Views Right BCE

    $83.10

This 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.

Cost Estimate

  • Total estimated charges

    $507.00

  • Insurance Discount

    -$423.90

  • Price Negotiated by Insurer

    $83.10

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

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.

  • Ammonia Level

    $14.57

  • Blood Culture

    $10.32

  • CBC w/ Diff

    $7.77

  • CHED 99285 - Level 5 BCE

    $587.42

  • CHED Arterial Line Activity Blood Drawn BCE

    $116.82

  • CHED PRESSD NONPRESSD INHAL TRMENT BCE

    $195.06

  • Comprehensive Metabolic Panel

    $10.56

  • Creatine Kinase

    $6.51

  • ED - Initial Admin Charge 90471

    $64.43

  • Lactic Acid Level

    $11.57

  • Lipase Level

    $6.89

  • Minimum Inhibitory Concentration

    $8.65

  • NT-proBNP SO

    $39.26

  • RT EKG 12 Lead Tracing BCE

    $55.94

  • Salicylate Level

    $62.14

  • SDS Inf Hydration Each Addl Hr 96361 BCE

    $43.44

  • SDS Tx Prophylactic Diag IVP Drug 96374 BCE

    $196.02

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest Abdomen Infant

    $83.10

  • XR Hip 2-3 Views Right BCE

    $83.10

  • XR Wrist 2 Views Right BCE

    $83.10

This 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.