CPT 70549
The standard charge for MRA scan of neck with and without contrast is $6,627.00. 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
$6,627.00Insurance Discount
-$6,270.81Price Negotiated by Insurer
$356.19Deductible 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.
83735 MAGNESIUM
$2.6185025 CBC W/AUTOMATED DIFFERENTIAL
$3.03Basic Metabolic Panel
$3.30CHED 96374- IV Injection, single/initial BCE
$32.40CHED 99285 - Level 5 BCE
$280.00CHED Routine ECG 12 lead/15 lead tracing only BCE
$60.57Comprehensive Metabolic Panel
$4.12CT Angio Brain/Head
$175.06CT Angio Neck
$175.06CT Brain Stroke Protocol w/o Contrast
$104.75EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$425.43ferrous gluconate 324 mg (38 mg elemental iron) Tab
$0.72gadoteridol 279.3 mg/mL IV Soln 10 mL
$11.52Gram positive identification (Vitek)
$3.15hydrALAZINE 20 mg/mL Inj Soln 1 mL
$11.54insulin isophane 100 units/mL human recombinant Subcut Susp 10 mL
$11.52iodixanol 320 mg/mL Inj Soln 100 mL
$19.53Lipase Level
$2.69Minimum Inhibitory Concentration
$3.37MRA Brain/Head w/o Contrast
$222.20MRI Brain w/ + w/o Contrast
$328.11NT-proBNP SO
$15.31Prothrombin Time (PT)
$1.67ROOM/BED: Observation
$400.00RT CHARGE SpO2 -> Single
$10.98sterile water Inj Soln 10 mL
$11.54Thromboplastin time, partial (PTT); plasma or whole blood
$2.34Troponin-I
$4.86Urinalysis Microscopic
$1.24Urine Culture
$3.16XR Chest
$25.73This 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
$6,627.00Insurance Discount
-$6,276.54Price 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.
83735 MAGNESIUM
$6.7085025 CBC W/AUTOMATED DIFFERENTIAL
$7.77Basic Metabolic Panel
$8.46CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56CT Angio Brain/Head
$176.20CT Angio Neck
$176.20CT Brain Stroke Protocol w/o Contrast
$105.02EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$548.90Gram positive identification (Vitek)
$8.08Lipase Level
$6.89Minimum Inhibitory Concentration
$8.65MRA Brain/Head w/o Contrast
$239.69MRI Brain w/ + w/o Contrast
$350.46NT-proBNP SO
$39.26Prothrombin Time (PT)
$4.29Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$72.33Thromboplastin time, partial (PTT); plasma or whole blood
$6.01Troponin-I
$12.47Urinalysis Microscopic
$3.17Urine Culture
$8.09XR Chest
$87.42This 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
$6,627.00Insurance Discount
-$6,276.54Price 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.
83735 MAGNESIUM
$6.7085025 CBC W/AUTOMATED DIFFERENTIAL
$7.77Basic Metabolic Panel
$8.46CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56CT Angio Brain/Head
$176.20CT Angio Neck
$176.20CT Brain Stroke Protocol w/o Contrast
$105.02EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$548.90Gram positive identification (Vitek)
$8.08Lipase Level
$6.89Minimum Inhibitory Concentration
$8.65MRA Brain/Head w/o Contrast
$239.69MRI Brain w/ + w/o Contrast
$350.46NT-proBNP SO
$39.26Prothrombin Time (PT)
$4.29Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$72.33Thromboplastin time, partial (PTT); plasma or whole blood
$6.01Troponin-I
$12.47Urinalysis Microscopic
$3.17Urine Culture
$8.09XR Chest
$87.42This 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
$6,627.00Insurance Discount
-$5,996.95Price Negotiated by Insurer
$630.05Deductible 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.
83735 MAGNESIUM
$70.2085025 CBC W/AUTOMATED DIFFERENTIAL
$116.10Basic Metabolic Panel
$148.80CHED 96374- IV Injection, single/initial BCE
$108.00CHED 99285 - Level 5 BCE
$2,640.00CHED Routine ECG 12 lead/15 lead tracing only BCE
$201.90Comprehensive Metabolic Panel
$198.30CT Angio Brain/Head
$300.66CT Angio Neck
$300.66CT Brain Stroke Protocol w/o Contrast
$184.93EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$1,418.10ferrous gluconate 324 mg (38 mg elemental iron) Tab
$2.40gadoteridol 279.3 mg/mL IV Soln 10 mL
$2.57Gram positive identification (Vitek)
$71.40hydrALAZINE 20 mg/mL Inj Soln 1 mL
$9.40insulin isophane 100 units/mL human recombinant Subcut Susp 10 mL
$0.20iodixanol 320 mg/mL Inj Soln 100 mL
$0.46Lipase Level
$82.20Minimum Inhibitory Concentration
$75.30MRA Brain/Head w/o Contrast
$384.52MRI Brain w/ + w/o Contrast
$630.05NT-proBNP SO
$149.70Prothrombin Time (PT)
$55.20ROOM/BED: Observation
$2,745.00RT CHARGE SpO2 -> Single
$36.60sterile water Inj Soln 10 mL
$0.64Thromboplastin time, partial (PTT); plasma or whole blood
$66.00Troponin-I
$132.60Urinalysis Microscopic
$56.40Urine Culture
$42.30XR Chest
$131.69This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,627.00Insurance Discount
-$5,870.94Price Negotiated by Insurer
$756.06Deductible 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.
83735 MAGNESIUM
$84.2485025 CBC W/AUTOMATED DIFFERENTIAL
$139.32Basic Metabolic Panel
$178.56CHED 96374- IV Injection, single/initial BCE
$129.60CHED 99285 - Level 5 BCE
$3,168.00CHED Routine ECG 12 lead/15 lead tracing only BCE
$242.28Comprehensive Metabolic Panel
$237.96CT Angio Brain/Head
$360.80CT Angio Neck
$360.80CT Brain Stroke Protocol w/o Contrast
$221.92EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$1,701.72ferrous gluconate 324 mg (38 mg elemental iron) Tab
$2.88gadoteridol 279.3 mg/mL IV Soln 10 mL
$3.08Gram positive identification (Vitek)
$85.68hydrALAZINE 20 mg/mL Inj Soln 1 mL
$11.28insulin isophane 100 units/mL human recombinant Subcut Susp 10 mL
$0.24iodixanol 320 mg/mL Inj Soln 100 mL
$0.56Lipase Level
$98.64Minimum Inhibitory Concentration
$90.36MRA Brain/Head w/o Contrast
$461.42MRI Brain w/ + w/o Contrast
$756.06NT-proBNP SO
$179.64Prothrombin Time (PT)
$66.24ROOM/BED: Observation
$3,294.00RT CHARGE SpO2 -> Single
$43.92sterile water Inj Soln 10 mL
$0.77Thromboplastin time, partial (PTT); plasma or whole blood
$79.20Troponin-I
$159.12Urinalysis Microscopic
$67.68Urine Culture
$50.76XR Chest
$158.02This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,627.00Insurance Discount
-$6,276.54Price 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.
83735 MAGNESIUM
$6.7085025 CBC W/AUTOMATED DIFFERENTIAL
$7.77Basic Metabolic Panel
$8.46CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56CT Angio Brain/Head
$176.20CT Angio Neck
$176.20CT Brain Stroke Protocol w/o Contrast
$105.02EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$548.90Gram positive identification (Vitek)
$8.08Lipase Level
$6.89Minimum Inhibitory Concentration
$8.65MRA Brain/Head w/o Contrast
$239.69MRI Brain w/ + w/o Contrast
$350.46NT-proBNP SO
$39.26Prothrombin Time (PT)
$4.29Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$72.33Thromboplastin time, partial (PTT); plasma or whole blood
$6.01Troponin-I
$12.47Urinalysis Microscopic
$3.17Urine Culture
$8.09XR Chest
$87.42This 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
$6,627.00Insurance Discount
-$5,783.11Price Negotiated by Insurer
$843.89Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
83735 MAGNESIUM
$93.6085025 CBC W/AUTOMATED DIFFERENTIAL
$154.80Basic Metabolic Panel
$198.40CHED 96374- IV Injection, single/initial BCE
$144.00CHED 99285 - Level 5 BCE
$3,520.00CHED Routine ECG 12 lead/15 lead tracing only BCE
$269.20Comprehensive Metabolic Panel
$264.40CT Angio Brain/Head
$402.71CT Angio Neck
$402.71CT Brain Stroke Protocol w/o Contrast
$247.70EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$1,890.80ferrous gluconate 324 mg (38 mg elemental iron) Tab
$3.20gadoteridol 279.3 mg/mL IV Soln 10 mL
$3.42Gram positive identification (Vitek)
$95.20hydrALAZINE 20 mg/mL Inj Soln 1 mL
$12.51insulin isophane 100 units/mL human recombinant Subcut Susp 10 mL
$0.27iodixanol 320 mg/mL Inj Soln 100 mL
$0.62Lipase Level
$109.60Minimum Inhibitory Concentration
$100.40MRA Brain/Head w/o Contrast
$515.02MRI Brain w/ + w/o Contrast
$843.89NT-proBNP SO
$199.60Prothrombin Time (PT)
$73.60ROOM/BED: Observation
$3,660.00RT CHARGE SpO2 -> Single
$48.80sterile water Inj Soln 10 mL
$0.85Thromboplastin time, partial (PTT); plasma or whole blood
$88.00Troponin-I
$176.80Urinalysis Microscopic
$75.20Urine Culture
$56.40XR Chest
$176.38This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,627.00Insurance Discount
-$2,120.64Price Negotiated by Insurer
$4,506.36Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
83735 MAGNESIUM
$159.1285025 CBC W/AUTOMATED DIFFERENTIAL
$263.16Basic Metabolic Panel
$337.28CHED 96374- IV Injection, single/initial BCE
$244.80CHED 99285 - Level 5 BCE
$2,067.20CHED Routine ECG 12 lead/15 lead tracing only BCE
$457.64Comprehensive Metabolic Panel
$449.48CT Angio Brain/Head
$4,727.36CT Angio Neck
$5,971.76CT Brain Stroke Protocol w/o Contrast
$3,056.60EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$3,214.36ferrous gluconate 324 mg (38 mg elemental iron) Tab
$5.44gadoteridol 279.3 mg/mL IV Soln 10 mL
$87.04Gram positive identification (Vitek)
$161.84hydrALAZINE 20 mg/mL Inj Soln 1 mL
$87.16insulin isophane 100 units/mL human recombinant Subcut Susp 10 mL
$87.04iodixanol 320 mg/mL Inj Soln 100 mL
$147.56Lipase Level
$186.32Minimum Inhibitory Concentration
$170.68MRA Brain/Head w/o Contrast
$3,901.16MRI Brain w/ + w/o Contrast
$6,093.48NT-proBNP SO
$339.32Prothrombin Time (PT)
$125.12ROOM/BED: Observation
$74.80RT CHARGE SpO2 -> Single
$82.96sterile water Inj Soln 10 mL
$87.16Thromboplastin time, partial (PTT); plasma or whole blood
$149.60Troponin-I
$300.56Urinalysis Microscopic
$127.84Urine Culture
$95.88XR Chest
$451.52This 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
$6,627.00Insurance Discount
-$5,886.19Price 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 96374- IV Injection, single/initial BCE
$451.67CHED 99285 - Level 5 BCE
$2,968.44CHED Routine ECG 12 lead/15 lead tracing only BCE
$125.27CT Angio Brain/Head
$372.46CT Angio Neck
$372.46CT Brain Stroke Protocol w/o Contrast
$222.00EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$1,160.29MRA Brain/Head w/o Contrast
$506.65MRI Brain w/ + w/o Contrast
$740.81Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$152.89XR Chest
$184.79This 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
$6,627.00Insurance Discount
-$1,855.56Price Negotiated by Insurer
$4,771.44Deductible 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.
83735 MAGNESIUM
$168.4885025 CBC W/AUTOMATED DIFFERENTIAL
$278.64Basic Metabolic Panel
$357.12CHED 96374- IV Injection, single/initial BCE
$259.20CHED 99285 - Level 5 BCE
$2,188.80CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56Comprehensive Metabolic Panel
$475.92CT Angio Brain/Head
$5,005.44CT Angio Neck
$6,323.04CT Brain Stroke Protocol w/o Contrast
$3,236.40EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$3,403.44ferrous gluconate 324 mg (38 mg elemental iron) Tab
$5.76gadoteridol 279.3 mg/mL IV Soln 10 mL
$92.16Gram positive identification (Vitek)
$171.36hydrALAZINE 20 mg/mL Inj Soln 1 mL
$92.28insulin isophane 100 units/mL human recombinant Subcut Susp 10 mL
$92.16iodixanol 320 mg/mL Inj Soln 100 mL
$156.24Lipase Level
$197.28Minimum Inhibitory Concentration
$180.72MRA Brain/Head w/o Contrast
$4,130.64MRI Brain w/ + w/o Contrast
$6,451.92NT-proBNP SO
$359.28Prothrombin Time (PT)
$132.48ROOM/BED: Observation
$79.20RT CHARGE SpO2 -> Single
$87.84sterile water Inj Soln 10 mL
$92.28Thromboplastin time, partial (PTT); plasma or whole blood
$158.40Troponin-I
$318.24Urinalysis Microscopic
$135.36Urine Culture
$101.52XR Chest
$478.08This 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
$6,627.00Insurance Discount
-$6,276.54Price 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.
83735 MAGNESIUM
$6.7085025 CBC W/AUTOMATED DIFFERENTIAL
$7.77Basic Metabolic Panel
$8.46CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56CT Angio Brain/Head
$176.20CT Angio Neck
$176.20CT Brain Stroke Protocol w/o Contrast
$105.02EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$548.90Gram positive identification (Vitek)
$8.08Lipase Level
$6.89Minimum Inhibitory Concentration
$8.65MRA Brain/Head w/o Contrast
$239.69MRI Brain w/ + w/o Contrast
$350.46NT-proBNP SO
$39.26Prothrombin Time (PT)
$4.29Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$72.33Thromboplastin time, partial (PTT); plasma or whole blood
$6.01Troponin-I
$12.47Urinalysis Microscopic
$3.17Urine Culture
$8.09XR Chest
$87.42This 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
$6,627.00Insurance Discount
-$6,276.54Price 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.
83735 MAGNESIUM
$6.7085025 CBC W/AUTOMATED DIFFERENTIAL
$7.77Basic Metabolic Panel
$8.46CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56CT Angio Brain/Head
$176.20CT Angio Neck
$176.20CT Brain Stroke Protocol w/o Contrast
$105.02EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$548.90Gram positive identification (Vitek)
$8.08Lipase Level
$6.89Minimum Inhibitory Concentration
$8.65MRA Brain/Head w/o Contrast
$239.69MRI Brain w/ + w/o Contrast
$350.46NT-proBNP SO
$39.26Prothrombin Time (PT)
$4.29Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$72.33Thromboplastin time, partial (PTT); plasma or whole blood
$6.01Troponin-I
$12.47Urinalysis Microscopic
$3.17Urine Culture
$8.09XR Chest
$87.42This 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
$6,627.00Insurance Discount
-$6,276.54Price 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.
83735 MAGNESIUM
$6.7085025 CBC W/AUTOMATED DIFFERENTIAL
$7.77Basic Metabolic Panel
$8.46CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56CT Angio Brain/Head
$176.20CT Angio Neck
$176.20CT Brain Stroke Protocol w/o Contrast
$105.02EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$548.90Gram positive identification (Vitek)
$8.08Lipase Level
$6.89Minimum Inhibitory Concentration
$8.65MRA Brain/Head w/o Contrast
$239.69MRI Brain w/ + w/o Contrast
$350.46NT-proBNP SO
$39.26Prothrombin Time (PT)
$4.29Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$72.33Thromboplastin time, partial (PTT); plasma or whole blood
$6.01Troponin-I
$12.47Urinalysis Microscopic
$3.17Urine Culture
$8.09XR Chest
$87.42This 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
$6,627.00Insurance Discount
-$1,855.56Price Negotiated by Insurer
$4,771.44Deductible 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.
83735 MAGNESIUM
$168.4885025 CBC W/AUTOMATED DIFFERENTIAL
$278.64Basic Metabolic Panel
$357.12CHED 96374- IV Injection, single/initial BCE
$259.20CHED 99285 - Level 5 BCE
$2,188.80CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56Comprehensive Metabolic Panel
$475.92CT Angio Brain/Head
$5,005.44CT Angio Neck
$6,323.04CT Brain Stroke Protocol w/o Contrast
$3,236.40EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$3,403.44ferrous gluconate 324 mg (38 mg elemental iron) Tab
$5.76gadoteridol 279.3 mg/mL IV Soln 10 mL
$92.16Gram positive identification (Vitek)
$171.36hydrALAZINE 20 mg/mL Inj Soln 1 mL
$92.28insulin isophane 100 units/mL human recombinant Subcut Susp 10 mL
$92.16iodixanol 320 mg/mL Inj Soln 100 mL
$156.24Lipase Level
$197.28Minimum Inhibitory Concentration
$180.72MRA Brain/Head w/o Contrast
$4,130.64MRI Brain w/ + w/o Contrast
$6,451.92NT-proBNP SO
$359.28Prothrombin Time (PT)
$132.48ROOM/BED: Observation
$79.20RT CHARGE SpO2 -> Single
$87.84sterile water Inj Soln 10 mL
$92.28Thromboplastin time, partial (PTT); plasma or whole blood
$158.40Troponin-I
$318.24Urinalysis Microscopic
$135.36Urine Culture
$101.52XR Chest
$478.08This 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
$6,627.00Insurance Discount
-$6,276.54Price 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.
83735 MAGNESIUM
$6.7085025 CBC W/AUTOMATED DIFFERENTIAL
$7.77Basic Metabolic Panel
$8.46CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56CT Angio Brain/Head
$176.20CT Angio Neck
$176.20CT Brain Stroke Protocol w/o Contrast
$105.02EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$548.90Gram positive identification (Vitek)
$8.08Lipase Level
$6.89Minimum Inhibitory Concentration
$8.65MRA Brain/Head w/o Contrast
$239.69MRI Brain w/ + w/o Contrast
$350.46NT-proBNP SO
$39.26Prothrombin Time (PT)
$4.29Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$72.33Thromboplastin time, partial (PTT); plasma or whole blood
$6.01Troponin-I
$12.47Urinalysis Microscopic
$3.17Urine Culture
$8.09XR Chest
$87.42This 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
$6,627.00Insurance Discount
-$6,276.54Price 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.
83735 MAGNESIUM
$6.7085025 CBC W/AUTOMATED DIFFERENTIAL
$7.77Basic Metabolic Panel
$8.46CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56CT Angio Brain/Head
$176.20CT Angio Neck
$176.20CT Brain Stroke Protocol w/o Contrast
$105.02EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$548.90Gram positive identification (Vitek)
$8.08Lipase Level
$6.89Minimum Inhibitory Concentration
$8.65MRA Brain/Head w/o Contrast
$239.69MRI Brain w/ + w/o Contrast
$350.46NT-proBNP SO
$39.26Prothrombin Time (PT)
$4.29Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$72.33Thromboplastin time, partial (PTT); plasma or whole blood
$6.01Troponin-I
$12.47Urinalysis Microscopic
$3.17Urine Culture
$8.09XR Chest
$87.42This 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
$6,627.00Insurance Discount
-$2,319.45Price Negotiated by Insurer
$4,307.55Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
83735 MAGNESIUM
$152.1085025 CBC W/AUTOMATED DIFFERENTIAL
$251.55Basic Metabolic Panel
$322.40CHED 96374- IV Injection, single/initial BCE
$234.00CHED 99285 - Level 5 BCE
$1,976.00CHED Routine ECG 12 lead/15 lead tracing only BCE
$437.45Comprehensive Metabolic Panel
$429.65CT Angio Brain/Head
$4,518.80CT Angio Neck
$5,708.30CT Brain Stroke Protocol w/o Contrast
$2,921.75EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$3,072.55ferrous gluconate 324 mg (38 mg elemental iron) Tab
$5.20gadoteridol 279.3 mg/mL IV Soln 10 mL
$83.20Gram positive identification (Vitek)
$154.70hydrALAZINE 20 mg/mL Inj Soln 1 mL
$83.31insulin isophane 100 units/mL human recombinant Subcut Susp 10 mL
$83.20iodixanol 320 mg/mL Inj Soln 100 mL
$141.05Lipase Level
$178.10Minimum Inhibitory Concentration
$163.15MRA Brain/Head w/o Contrast
$3,729.05MRI Brain w/ + w/o Contrast
$5,824.65NT-proBNP SO
$324.35Prothrombin Time (PT)
$119.60ROOM/BED: Observation
$71.50RT CHARGE SpO2 -> Single
$79.30sterile water Inj Soln 10 mL
$83.31Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$10,000.00Thromboplastin time, partial (PTT); plasma or whole blood
$143.00Troponin-I
$287.30Urinalysis Microscopic
$122.20Urine Culture
$91.65XR Chest
$431.60This 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
$6,627.00Insurance Discount
-$2,319.45Price Negotiated by Insurer
$4,307.55Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
83735 MAGNESIUM
$152.1085025 CBC W/AUTOMATED DIFFERENTIAL
$251.55Basic Metabolic Panel
$322.40CHED 96374- IV Injection, single/initial BCE
$234.00CHED 99285 - Level 5 BCE
$1,976.00CHED Routine ECG 12 lead/15 lead tracing only BCE
$437.45Comprehensive Metabolic Panel
$429.65CT Angio Brain/Head
$4,518.80CT Angio Neck
$5,708.30CT Brain Stroke Protocol w/o Contrast
$2,921.75EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$3,072.55ferrous gluconate 324 mg (38 mg elemental iron) Tab
$5.20gadoteridol 279.3 mg/mL IV Soln 10 mL
$83.20Gram positive identification (Vitek)
$154.70hydrALAZINE 20 mg/mL Inj Soln 1 mL
$83.31insulin isophane 100 units/mL human recombinant Subcut Susp 10 mL
$83.20iodixanol 320 mg/mL Inj Soln 100 mL
$141.05Lipase Level
$178.10Minimum Inhibitory Concentration
$163.15MRA Brain/Head w/o Contrast
$3,729.05MRI Brain w/ + w/o Contrast
$5,824.65NT-proBNP SO
$324.35Prothrombin Time (PT)
$119.60ROOM/BED: Observation
$71.50RT CHARGE SpO2 -> Single
$79.30sterile water Inj Soln 10 mL
$83.31Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$10,000.00Thromboplastin time, partial (PTT); plasma or whole blood
$143.00Troponin-I
$287.30Urinalysis Microscopic
$122.20Urine Culture
$91.65XR Chest
$431.60This 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
$6,627.00Insurance Discount
-$2,319.45Price Negotiated by Insurer
$4,307.55Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
83735 MAGNESIUM
$152.1085025 CBC W/AUTOMATED DIFFERENTIAL
$251.55Basic Metabolic Panel
$322.40CHED 96374- IV Injection, single/initial BCE
$234.00CHED 99285 - Level 5 BCE
$1,976.00CHED Routine ECG 12 lead/15 lead tracing only BCE
$437.45Comprehensive Metabolic Panel
$429.65CT Angio Brain/Head
$4,518.80CT Angio Neck
$5,708.30CT Brain Stroke Protocol w/o Contrast
$2,921.75EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$3,072.55ferrous gluconate 324 mg (38 mg elemental iron) Tab
$5.20gadoteridol 279.3 mg/mL IV Soln 10 mL
$83.20Gram positive identification (Vitek)
$154.70hydrALAZINE 20 mg/mL Inj Soln 1 mL
$83.31insulin isophane 100 units/mL human recombinant Subcut Susp 10 mL
$83.20iodixanol 320 mg/mL Inj Soln 100 mL
$141.05Lipase Level
$178.10Minimum Inhibitory Concentration
$163.15MRA Brain/Head w/o Contrast
$3,729.05MRI Brain w/ + w/o Contrast
$5,824.65NT-proBNP SO
$324.35Prothrombin Time (PT)
$119.60ROOM/BED: Observation
$71.50RT CHARGE SpO2 -> Single
$79.30sterile water Inj Soln 10 mL
$83.31Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$10,000.00Thromboplastin time, partial (PTT); plasma or whole blood
$143.00Troponin-I
$287.30Urinalysis Microscopic
$122.20Urine Culture
$91.65XR Chest
$431.60This 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
$6,627.00Insurance Discount
-$1,855.56Price Negotiated by Insurer
$4,771.44Deductible 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.
83735 MAGNESIUM
$168.4885025 CBC W/AUTOMATED DIFFERENTIAL
$278.64Basic Metabolic Panel
$357.12CHED 96374- IV Injection, single/initial BCE
$259.20CHED 99285 - Level 5 BCE
$2,188.80CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56Comprehensive Metabolic Panel
$475.92CT Angio Brain/Head
$5,005.44CT Angio Neck
$6,323.04CT Brain Stroke Protocol w/o Contrast
$3,236.40EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$3,403.44ferrous gluconate 324 mg (38 mg elemental iron) Tab
$5.76gadoteridol 279.3 mg/mL IV Soln 10 mL
$92.16Gram positive identification (Vitek)
$171.36hydrALAZINE 20 mg/mL Inj Soln 1 mL
$92.28insulin isophane 100 units/mL human recombinant Subcut Susp 10 mL
$92.16iodixanol 320 mg/mL Inj Soln 100 mL
$156.24Lipase Level
$197.28Minimum Inhibitory Concentration
$180.72MRA Brain/Head w/o Contrast
$4,130.64MRI Brain w/ + w/o Contrast
$6,451.92NT-proBNP SO
$359.28Prothrombin Time (PT)
$132.48ROOM/BED: Observation
$79.20RT CHARGE SpO2 -> Single
$87.84sterile water Inj Soln 10 mL
$92.28Thromboplastin time, partial (PTT); plasma or whole blood
$158.40Troponin-I
$318.24Urinalysis Microscopic
$135.36Urine Culture
$101.52XR Chest
$478.08This 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
$6,627.00Insurance Discount
-$3,313.50Price Negotiated by Insurer
$3,313.50Deductible 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.
83735 MAGNESIUM
$8.3885025 CBC W/AUTOMATED DIFFERENTIAL
$9.71Basic Metabolic Panel
$10.57CHED 96374- IV Injection, single/initial BCE
$180.00CHED 99285 - Level 5 BCE
$2,900.00CHED Routine ECG 12 lead/15 lead tracing only BCE
$336.50Comprehensive Metabolic Panel
$13.20CT Angio Brain/Head
$3,476.00CT Angio Neck
$4,391.00CT Brain Stroke Protocol w/o Contrast
$2,247.50EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$2,363.50ferrous gluconate 324 mg (38 mg elemental iron) Tab
$4.00gadoteridol 279.3 mg/mL IV Soln 10 mL
$64.00Gram positive identification (Vitek)
$10.10hydrALAZINE 20 mg/mL Inj Soln 1 mL
$64.08insulin isophane 100 units/mL human recombinant Subcut Susp 10 mL
$64.00iodixanol 320 mg/mL Inj Soln 100 mL
$108.50Lipase Level
$8.61Minimum Inhibitory Concentration
$10.81MRA Brain/Head w/o Contrast
$2,868.50MRI Brain w/ + w/o Contrast
$4,480.50NT-proBNP SO
$49.08Prothrombin Time (PT)
$5.36ROOM/BED: Observation
$55.00RT CHARGE SpO2 -> Single
$61.00sterile water Inj Soln 10 mL
$64.08Thromboplastin time, partial (PTT); plasma or whole blood
$7.51Troponin-I
$15.59Urinalysis Microscopic
$3.96Urine Culture
$10.11XR Chest
$131.13This 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
$6,627.00Insurance Discount
-$6,276.54Price 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.
83735 MAGNESIUM
$6.7085025 CBC W/AUTOMATED DIFFERENTIAL
$7.77Basic Metabolic Panel
$8.46CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56CT Angio Brain/Head
$176.20CT Angio Neck
$176.20CT Brain Stroke Protocol w/o Contrast
$105.02EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$548.90Gram positive identification (Vitek)
$8.08Lipase Level
$6.89Minimum Inhibitory Concentration
$8.65MRA Brain/Head w/o Contrast
$239.69MRI Brain w/ + w/o Contrast
$350.46NT-proBNP SO
$39.26Prothrombin Time (PT)
$4.29Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$72.33Thromboplastin time, partial (PTT); plasma or whole blood
$6.01Troponin-I
$12.47Urinalysis Microscopic
$3.17Urine Culture
$8.09XR Chest
$87.42This 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
$6,627.00Insurance Discount
-$1,855.56Price Negotiated by Insurer
$4,771.44Deductible 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.
83735 MAGNESIUM
$168.4885025 CBC W/AUTOMATED DIFFERENTIAL
$278.64Basic Metabolic Panel
$357.12CHED 96374- IV Injection, single/initial BCE
$259.20CHED 99285 - Level 5 BCE
$2,188.80CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56Comprehensive Metabolic Panel
$475.92CT Angio Brain/Head
$5,005.44CT Angio Neck
$6,323.04CT Brain Stroke Protocol w/o Contrast
$3,236.40EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$3,403.44ferrous gluconate 324 mg (38 mg elemental iron) Tab
$5.76gadoteridol 279.3 mg/mL IV Soln 10 mL
$92.16Gram positive identification (Vitek)
$171.36hydrALAZINE 20 mg/mL Inj Soln 1 mL
$92.28insulin isophane 100 units/mL human recombinant Subcut Susp 10 mL
$92.16iodixanol 320 mg/mL Inj Soln 100 mL
$156.24Lipase Level
$197.28Minimum Inhibitory Concentration
$180.72MRA Brain/Head w/o Contrast
$4,130.64MRI Brain w/ + w/o Contrast
$6,451.92NT-proBNP SO
$359.28Prothrombin Time (PT)
$132.48ROOM/BED: Observation
$79.20RT CHARGE SpO2 -> Single
$87.84sterile water Inj Soln 10 mL
$92.28Thromboplastin time, partial (PTT); plasma or whole blood
$158.40Troponin-I
$318.24Urinalysis Microscopic
$135.36Urine Culture
$101.52XR Chest
$478.08This 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
$6,627.00Insurance Discount
-$6,276.54Price 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.
83735 MAGNESIUM
$6.7085025 CBC W/AUTOMATED DIFFERENTIAL
$7.77Basic Metabolic Panel
$8.46CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56CT Angio Brain/Head
$176.20CT Angio Neck
$176.20CT Brain Stroke Protocol w/o Contrast
$105.02EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$548.90ferrous gluconate 324 mg (38 mg elemental iron) Tab
$1.09gadoteridol 279.3 mg/mL IV Soln 10 mL
$17.41Gram positive identification (Vitek)
$8.08hydrALAZINE 20 mg/mL Inj Soln 1 mL
$17.43insulin isophane 100 units/mL human recombinant Subcut Susp 10 mL
$17.41iodixanol 320 mg/mL Inj Soln 100 mL
$29.51Lipase Level
$6.89Minimum Inhibitory Concentration
$8.65MRA Brain/Head w/o Contrast
$239.69MRI Brain w/ + w/o Contrast
$350.46NT-proBNP SO
$39.26Prothrombin Time (PT)
$4.29ROOM/BED: Observation
$14.96RT CHARGE SpO2 -> Single
$16.59sterile water Inj Soln 10 mL
$17.43Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$72.33Thromboplastin time, partial (PTT); plasma or whole blood
$6.01Troponin-I
$12.47Urinalysis Microscopic
$3.17Urine Culture
$8.09XR Chest
$87.42This 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
$6,627.00Insurance Discount
-$6,276.54Price 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.
83735 MAGNESIUM
$6.7085025 CBC W/AUTOMATED DIFFERENTIAL
$7.77Basic Metabolic Panel
$8.46CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56CT Angio Brain/Head
$176.20CT Angio Neck
$176.20CT Brain Stroke Protocol w/o Contrast
$105.02EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$548.90Gram positive identification (Vitek)
$8.08Lipase Level
$6.89Minimum Inhibitory Concentration
$8.65MRA Brain/Head w/o Contrast
$239.69MRI Brain w/ + w/o Contrast
$350.46NT-proBNP SO
$39.26Prothrombin Time (PT)
$4.29Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$72.33Thromboplastin time, partial (PTT); plasma or whole blood
$6.01Troponin-I
$12.47Urinalysis Microscopic
$3.17Urine Culture
$8.09XR Chest
$87.42This 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
$6,627.00Insurance Discount
-$6,276.54Price 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.
83735 MAGNESIUM
$6.7085025 CBC W/AUTOMATED DIFFERENTIAL
$7.77Basic Metabolic Panel
$8.46CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56CT Angio Brain/Head
$176.20CT Angio Neck
$176.20CT Brain Stroke Protocol w/o Contrast
$105.02EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$548.90Gram positive identification (Vitek)
$8.08Lipase Level
$6.89Minimum Inhibitory Concentration
$8.65MRA Brain/Head w/o Contrast
$239.69MRI Brain w/ + w/o Contrast
$350.46NT-proBNP SO
$39.26Prothrombin Time (PT)
$4.29Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$72.33Thromboplastin time, partial (PTT); plasma or whole blood
$6.01Troponin-I
$12.47Urinalysis Microscopic
$3.17Urine Culture
$8.09XR Chest
$87.42This 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
$6,627.00Insurance Discount
-$6,276.54Price 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.
83735 MAGNESIUM
$6.7085025 CBC W/AUTOMATED DIFFERENTIAL
$7.77Basic Metabolic Panel
$8.46CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56CT Angio Brain/Head
$176.20CT Angio Neck
$176.20CT Brain Stroke Protocol w/o Contrast
$105.02EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$548.90Gram positive identification (Vitek)
$8.08Lipase Level
$6.89Minimum Inhibitory Concentration
$8.65MRA Brain/Head w/o Contrast
$239.69MRI Brain w/ + w/o Contrast
$350.46NT-proBNP SO
$39.26Prothrombin Time (PT)
$4.29Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$72.33Thromboplastin time, partial (PTT); plasma or whole blood
$6.01Troponin-I
$12.47Urinalysis Microscopic
$3.17Urine Culture
$8.09XR Chest
$87.42This 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
$6,627.00Insurance Discount
-$6,276.54Price 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.
83735 MAGNESIUM
$6.7085025 CBC W/AUTOMATED DIFFERENTIAL
$7.77Basic Metabolic Panel
$8.46CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56CT Angio Brain/Head
$176.20CT Angio Neck
$176.20CT Brain Stroke Protocol w/o Contrast
$105.02EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$548.90Gram positive identification (Vitek)
$8.08Lipase Level
$6.89Minimum Inhibitory Concentration
$8.65MRA Brain/Head w/o Contrast
$239.69MRI Brain w/ + w/o Contrast
$350.46NT-proBNP SO
$39.26Prothrombin Time (PT)
$4.29Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$72.33Thromboplastin time, partial (PTT); plasma or whole blood
$6.01Troponin-I
$12.47Urinalysis Microscopic
$3.17Urine Culture
$8.09XR Chest
$87.42This 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
$6,627.00Insurance Discount
-$6,276.54Price 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.
83735 MAGNESIUM
$6.7085025 CBC W/AUTOMATED DIFFERENTIAL
$7.77Basic Metabolic Panel
$8.46CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56CT Angio Brain/Head
$176.20CT Angio Neck
$176.20CT Brain Stroke Protocol w/o Contrast
$105.02EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306
$548.90Gram positive identification (Vitek)
$8.08Lipase Level
$6.89Minimum Inhibitory Concentration
$8.65MRA Brain/Head w/o Contrast
$239.69MRI Brain w/ + w/o Contrast
$350.46NT-proBNP SO
$39.26Prothrombin Time (PT)
$4.29Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr
$72.33Thromboplastin time, partial (PTT); plasma or whole blood
$6.01Troponin-I
$12.47Urinalysis Microscopic
$3.17Urine Culture
$8.09XR Chest
$87.42This 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.