CPT 47562
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
Price Negotiated by Insurer
$7,210.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$8.16Comprehensive Metabolic Panel
$11.10L&D Tx Proph Diag Seq IVP Same Drug 96376 BCE
$181.50RT EKG 12 Lead Tracing BCE
$10.11SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$84.15SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$165.00SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$181.50This 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
Price Negotiated by Insurer
$7,915.38Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$11.66Comprehensive Metabolic Panel
$15.84RT EKG 12 Lead Tracing BCE
$83.91SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$65.16SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$294.03SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$65.16This 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
Price Negotiated by Insurer
$1,888.85Deductible 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.
albuterol 2.5 mg/3 mL (0.083%) Inh Soln 3 mL
$11.54CBC w/ Diff
$3.03Comprehensive Metabolic Panel
$4.12fentaNYL 50 mcg/mL Inj Soln 50 mL
$11.54glycopyrrolate 0.2 mg 1 ml vial
$11.54ketorolac 30 mg/mL Inj Soln 1 mL
$11.54L&D Tx Proph Diag Seq IVP Same Drug 96376 BCE
$29.70lidocaine 1% Inj Soln 30 mL
$11.54midazolam 5 mg/mL Inj Soln 10 mL
$11.54neostigmine 1 mg/mL IV Soln 10 mL (Bloxiverz)
$11.52ondansetron 2 mg/mL Inj Soln 2 mL
$11.52oxyCODONE 10 mg ER Tab
$0.72propofol 10 mg/mL IV Emulsion 100 mL
$11.54RT EKG 12 Lead Tracing BCE
$63.00SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$13.77SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$27.00SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$29.70Sodium Chloride 0.9% IV Soln 500 mL
$11.54This 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
Price Negotiated by Insurer
$5,276.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44This 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
Price Negotiated by Insurer
$5,276.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44This 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
Price Negotiated by Insurer
$8,072.30Deductible 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.
albuterol 2.5 mg/3 mL (0.083%) Inh Soln 3 mL
$0.12CBC w/ Diff
$12.82Comprehensive Metabolic Panel
$17.42fentaNYL 50 mcg/mL Inj Soln 50 mL
$0.57glycopyrrolate 0.2 mg 1 ml vial
$0.99ketorolac 30 mg/mL Inj Soln 1 mL
$0.26L&D Tx Proph Diag Seq IVP Same Drug 96376 BCE
$41.39lidocaine 1% Inj Soln 30 mL
$38.45midazolam 5 mg/mL Inj Soln 10 mL
$0.12neostigmine 1 mg/mL IV Soln 10 mL (Bloxiverz)
$1.30ondansetron 2 mg/mL Inj Soln 2 mL
$0.86oxyCODONE 10 mg ER Tab
$2.40propofol 10 mg/mL IV Emulsion 100 mL
$0.25RT EKG 12 Lead Tracing BCE
$95.72SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$38.25SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$126.67SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$29.48Sodium Chloride 0.9% IV Soln 500 mL
$10.80This 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
Price Negotiated by Insurer
$9,667.42Deductible 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.
albuterol 2.5 mg/3 mL (0.083%) Inh Soln 3 mL
$0.14CBC w/ Diff
$15.38Comprehensive Metabolic Panel
$20.91fentaNYL 50 mcg/mL Inj Soln 50 mL
$0.68glycopyrrolate 0.2 mg 1 ml vial
$1.18ketorolac 30 mg/mL Inj Soln 1 mL
$0.31L&D Tx Proph Diag Seq IVP Same Drug 96376 BCE
$49.48lidocaine 1% Inj Soln 30 mL
$46.14midazolam 5 mg/mL Inj Soln 10 mL
$0.14neostigmine 1 mg/mL IV Soln 10 mL (Bloxiverz)
$1.57ondansetron 2 mg/mL Inj Soln 2 mL
$1.03oxyCODONE 10 mg ER Tab
$2.88propofol 10 mg/mL IV Emulsion 100 mL
$0.30RT EKG 12 Lead Tracing BCE
$114.42SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$45.72SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$151.42SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$35.24Sodium Chloride 0.9% IV Soln 500 mL
$12.96This 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
Price Negotiated by Insurer
$5,276.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44This 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
Price Negotiated by Insurer
$12,180.95Deductible 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.
albuterol 2.5 mg/3 mL (0.083%) Inh Soln 3 mL
$0.15CBC w/ Diff
$17.17Comprehensive Metabolic Panel
$23.34fentaNYL 50 mcg/mL Inj Soln 50 mL
$0.75glycopyrrolate 0.2 mg 1 ml vial
$1.31ketorolac 30 mg/mL Inj Soln 1 mL
$0.35L&D Tx Proph Diag Seq IVP Same Drug 96376 BCE
$55.19lidocaine 1% Inj Soln 30 mL
$51.27midazolam 5 mg/mL Inj Soln 10 mL
$0.15neostigmine 1 mg/mL IV Soln 10 mL (Bloxiverz)
$1.74ondansetron 2 mg/mL Inj Soln 2 mL
$1.14oxyCODONE 10 mg ER Tab
$3.20propofol 10 mg/mL IV Emulsion 100 mL
$0.33RT EKG 12 Lead Tracing BCE
$127.62SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$50.99SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$168.90SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$39.30Sodium Chloride 0.9% IV Soln 500 mL
$14.38This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
Price Negotiated by Insurer
$11,953.74Deductible 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.
RT EKG 12 Lead Tracing BCE
$126.71SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$98.40SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$444.05SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$98.40This 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
Price Negotiated by Insurer
$1,888.85Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56This 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
Price Negotiated by Insurer
$5,276.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44This 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
Price Negotiated by Insurer
$5,276.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44This 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
Price Negotiated by Insurer
$5,276.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44This 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
Price Negotiated by Insurer
$1,888.85Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56This 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
Price Negotiated by Insurer
$5,276.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44This 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
Price Negotiated by Insurer
$5,276.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44This 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
Price Negotiated by Insurer
$10,000.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
albuterol 2.5 mg/3 mL (0.083%) Inh Soln 3 mL
$83.31CBC w/ Diff
$121.55Comprehensive Metabolic Panel
$429.65fentaNYL 50 mcg/mL Inj Soln 50 mL
$83.32glycopyrrolate 0.2 mg 1 ml vial
$83.31ketorolac 30 mg/mL Inj Soln 1 mL
$83.31L&D Tx Proph Diag Seq IVP Same Drug 96376 BCE
$214.50lidocaine 1% Inj Soln 30 mL
$83.31midazolam 5 mg/mL Inj Soln 10 mL
$83.32neostigmine 1 mg/mL IV Soln 10 mL (Bloxiverz)
$83.20ondansetron 2 mg/mL Inj Soln 2 mL
$83.20oxyCODONE 10 mg ER Tab
$5.20propofol 10 mg/mL IV Emulsion 100 mL
$83.31RT EKG 12 Lead Tracing BCE
$455.00SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$99.45SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$195.00SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$214.50Sodium Chloride 0.9% IV Soln 500 mL
$83.31This 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
Price Negotiated by Insurer
$10,000.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
albuterol 2.5 mg/3 mL (0.083%) Inh Soln 3 mL
$83.31CBC w/ Diff
$121.55Comprehensive Metabolic Panel
$429.65fentaNYL 50 mcg/mL Inj Soln 50 mL
$83.32glycopyrrolate 0.2 mg 1 ml vial
$83.31ketorolac 30 mg/mL Inj Soln 1 mL
$83.31L&D Tx Proph Diag Seq IVP Same Drug 96376 BCE
$214.50lidocaine 1% Inj Soln 30 mL
$83.31midazolam 5 mg/mL Inj Soln 10 mL
$83.32neostigmine 1 mg/mL IV Soln 10 mL (Bloxiverz)
$83.20ondansetron 2 mg/mL Inj Soln 2 mL
$83.20oxyCODONE 10 mg ER Tab
$5.20propofol 10 mg/mL IV Emulsion 100 mL
$83.31RT EKG 12 Lead Tracing BCE
$455.00SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$99.45SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$195.00SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$214.50Sodium Chloride 0.9% IV Soln 500 mL
$83.31This 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
Price Negotiated by Insurer
$10,000.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
albuterol 2.5 mg/3 mL (0.083%) Inh Soln 3 mL
$83.31CBC w/ Diff
$121.55Comprehensive Metabolic Panel
$429.65fentaNYL 50 mcg/mL Inj Soln 50 mL
$83.32glycopyrrolate 0.2 mg 1 ml vial
$83.31ketorolac 30 mg/mL Inj Soln 1 mL
$83.31L&D Tx Proph Diag Seq IVP Same Drug 96376 BCE
$214.50lidocaine 1% Inj Soln 30 mL
$83.31midazolam 5 mg/mL Inj Soln 10 mL
$83.32neostigmine 1 mg/mL IV Soln 10 mL (Bloxiverz)
$83.20ondansetron 2 mg/mL Inj Soln 2 mL
$83.20oxyCODONE 10 mg ER Tab
$5.20propofol 10 mg/mL IV Emulsion 100 mL
$83.31RT EKG 12 Lead Tracing BCE
$455.00SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$99.45SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$195.00SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$214.50Sodium Chloride 0.9% IV Soln 500 mL
$83.31This 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
Price Negotiated by Insurer
$1,888.85Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56This 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
Price Negotiated by Insurer
$116.39Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
albuterol 2.5 mg/3 mL (0.083%) Inh Soln 3 mL
$64.08CBC w/ Diff
$9.71Comprehensive Metabolic Panel
$13.20fentaNYL 50 mcg/mL Inj Soln 50 mL
$64.10glycopyrrolate 0.2 mg 1 ml vial
$64.08ketorolac 30 mg/mL Inj Soln 1 mL
$64.08L&D Tx Proph Diag Seq IVP Same Drug 96376 BCE
$165.00lidocaine 1% Inj Soln 30 mL
$64.08midazolam 5 mg/mL Inj Soln 10 mL
$64.10neostigmine 1 mg/mL IV Soln 10 mL (Bloxiverz)
$64.00ondansetron 2 mg/mL Inj Soln 2 mL
$64.00oxyCODONE 10 mg ER Tab
$4.00propofol 10 mg/mL IV Emulsion 100 mL
$64.08RT EKG 12 Lead Tracing BCE
$1.00SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$0.78SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$3.51SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$0.78Sodium Chloride 0.9% IV Soln 500 mL
$64.08This 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
Price Negotiated by Insurer
$5,276.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44This 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
Price Negotiated by Insurer
$1,888.85Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56This 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
Price Negotiated by Insurer
$5,276.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
albuterol 2.5 mg/3 mL (0.083%) Inh Soln 3 mL
$17.43CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56fentaNYL 50 mcg/mL Inj Soln 50 mL
$17.43glycopyrrolate 0.2 mg 1 ml vial
$17.43ketorolac 30 mg/mL Inj Soln 1 mL
$17.43L&D Tx Proph Diag Seq IVP Same Drug 96376 BCE
$44.88lidocaine 1% Inj Soln 30 mL
$17.43midazolam 5 mg/mL Inj Soln 10 mL
$17.43neostigmine 1 mg/mL IV Soln 10 mL (Bloxiverz)
$17.41ondansetron 2 mg/mL Inj Soln 2 mL
$17.41oxyCODONE 10 mg ER Tab
$1.09propofol 10 mg/mL IV Emulsion 100 mL
$17.43RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44Sodium Chloride 0.9% IV Soln 500 mL
$17.43This 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
Price Negotiated by Insurer
$5,276.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44This 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
Price Negotiated by Insurer
$5,276.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44This 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
Price Negotiated by Insurer
$5,276.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44This 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
Price Negotiated by Insurer
$5,276.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44This 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
Price Negotiated by Insurer
$5,276.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44This 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.