CPT 74174
The standard charge for CTA scan of abdomen is $12,903.00. 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
$12,903.00Insurance Discount
-$12,536.58Price Negotiated by Insurer
$366.42Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$3.03CHED Routine ECG 12 lead/15 lead tracing only BCE
$60.57Comprehensive Metabolic Panel
$4.12iodixanol 320 mg/mL Inj Soln 100 mL
$19.53Sodium Chloride 0.9% IV Soln 50 mL
$11.54Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$29.70This 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
$12,903.00Insurance Discount
-$12,552.54Price Negotiated by Insurer
$350.46Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$47.04This 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
$12,903.00Insurance Discount
-$12,552.54Price Negotiated by Insurer
$350.46Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$47.04This 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
$12,903.00Insurance Discount
-$12,423.71Price Negotiated by Insurer
$479.29Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$116.10CHED Routine ECG 12 lead/15 lead tracing only BCE
$201.90Comprehensive Metabolic Panel
$198.30iodixanol 320 mg/mL Inj Soln 100 mL
$0.46Sodium Chloride 0.9% IV Soln 50 mL
$10.80Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$99.00This 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
$12,903.00Insurance Discount
-$12,327.85Price Negotiated by Insurer
$575.15Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$139.32CHED Routine ECG 12 lead/15 lead tracing only BCE
$242.28Comprehensive Metabolic Panel
$237.96iodixanol 320 mg/mL Inj Soln 100 mL
$0.56Sodium Chloride 0.9% IV Soln 50 mL
$12.96Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$118.80This 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
$12,903.00Insurance Discount
-$12,552.54Price Negotiated by Insurer
$350.46Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$47.04This 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
$12,903.00Insurance Discount
-$12,261.04Price Negotiated by Insurer
$641.96Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$154.80CHED Routine ECG 12 lead/15 lead tracing only BCE
$269.20Comprehensive Metabolic Panel
$264.40iodixanol 320 mg/mL Inj Soln 100 mL
$0.62Sodium Chloride 0.9% IV Soln 50 mL
$14.38Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$132.00This 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
$12,903.00Insurance Discount
-$4,128.96Price Negotiated by Insurer
$8,774.04Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$263.16CHED Routine ECG 12 lead/15 lead tracing only BCE
$457.64Comprehensive Metabolic Panel
$449.48iodixanol 320 mg/mL Inj Soln 100 mL
$147.56Sodium Chloride 0.9% IV Soln 50 mL
$87.16Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$224.40This 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
$12,903.00Insurance Discount
-$12,162.19Price Negotiated by Insurer
$740.81Deductible 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 Routine ECG 12 lead/15 lead tracing only BCE
$125.27Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$99.43This 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
$12,903.00Insurance Discount
-$3,612.84Price Negotiated by Insurer
$9,290.16Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$278.64CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56Comprehensive Metabolic Panel
$475.92iodixanol 320 mg/mL Inj Soln 100 mL
$156.24Sodium Chloride 0.9% IV Soln 50 mL
$92.28Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$237.60This 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
$12,903.00Insurance Discount
-$12,552.54Price Negotiated by Insurer
$350.46Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$47.04This 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
$12,903.00Insurance Discount
-$12,552.54Price Negotiated by Insurer
$350.46Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$47.04This 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
$12,903.00Insurance Discount
-$12,552.54Price Negotiated by Insurer
$350.46Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$47.04This 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
$12,903.00Insurance Discount
-$3,612.84Price Negotiated by Insurer
$9,290.16Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$278.64CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56Comprehensive Metabolic Panel
$475.92iodixanol 320 mg/mL Inj Soln 100 mL
$156.24Sodium Chloride 0.9% IV Soln 50 mL
$92.28Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$237.60This 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
$12,903.00Insurance Discount
-$12,552.54Price Negotiated by Insurer
$350.46Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$47.04This 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
$12,903.00Insurance Discount
-$12,552.54Price Negotiated by Insurer
$350.46Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$47.04This 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
$12,903.00Insurance Discount
-$4,516.05Price Negotiated by Insurer
$8,386.95Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$251.55CHED Routine ECG 12 lead/15 lead tracing only BCE
$437.45Comprehensive Metabolic Panel
$429.65iodixanol 320 mg/mL Inj Soln 100 mL
$141.05Sodium Chloride 0.9% IV Soln 50 mL
$83.31Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$214.50This 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
$12,903.00Insurance Discount
-$4,516.05Price Negotiated by Insurer
$8,386.95Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$251.55CHED Routine ECG 12 lead/15 lead tracing only BCE
$437.45Comprehensive Metabolic Panel
$429.65iodixanol 320 mg/mL Inj Soln 100 mL
$141.05Sodium Chloride 0.9% IV Soln 50 mL
$83.31Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$214.50This 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
$12,903.00Insurance Discount
-$4,516.05Price Negotiated by Insurer
$8,386.95Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$251.55CHED Routine ECG 12 lead/15 lead tracing only BCE
$437.45Comprehensive Metabolic Panel
$429.65iodixanol 320 mg/mL Inj Soln 100 mL
$141.05Sodium Chloride 0.9% IV Soln 50 mL
$83.31Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$214.50This 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
$12,903.00Insurance Discount
-$3,612.84Price Negotiated by Insurer
$9,290.16Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$278.64CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56Comprehensive Metabolic Panel
$475.92iodixanol 320 mg/mL Inj Soln 100 mL
$156.24Sodium Chloride 0.9% IV Soln 50 mL
$92.28Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$237.60This 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
$12,903.00Insurance Discount
-$12,420.84Price Negotiated by Insurer
$482.16Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$9.71CHED Routine ECG 12 lead/15 lead tracing only BCE
$7.78Comprehensive Metabolic Panel
$13.20iodixanol 320 mg/mL Inj Soln 100 mL
$0.15Sodium Chloride 0.9% IV Soln 50 mL
$64.08Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$18.93This 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
$12,903.00Insurance Discount
-$12,552.54Price Negotiated by Insurer
$350.46Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$47.04This 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
$12,903.00Insurance Discount
-$3,612.84Price Negotiated by Insurer
$9,290.16Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$278.64CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56Comprehensive Metabolic Panel
$475.92iodixanol 320 mg/mL Inj Soln 100 mL
$156.24Sodium Chloride 0.9% IV Soln 50 mL
$92.28Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$237.60This 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
$12,903.00Insurance Discount
-$12,552.54Price Negotiated by Insurer
$350.46Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56iodixanol 320 mg/mL Inj Soln 100 mL
$29.51Sodium Chloride 0.9% IV Soln 50 mL
$17.43Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$47.04This 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
$12,903.00Insurance Discount
-$12,552.54Price Negotiated by Insurer
$350.46Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$47.04This 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
$12,903.00Insurance Discount
-$12,552.54Price Negotiated by Insurer
$350.46Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$47.04This 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
$12,903.00Insurance Discount
-$12,552.54Price Negotiated by Insurer
$350.46Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$47.04This 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
$12,903.00Insurance Discount
-$12,552.54Price Negotiated by Insurer
$350.46Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$47.04This 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
$12,903.00Insurance Discount
-$12,552.54Price Negotiated by Insurer
$350.46Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$47.04This 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.