CPT 76775

Ultrasound of back wall of the abdomen with limited areas viewed

The standard charge for Ultrasound of back wall of the abdomen with limited areas viewed is $425.36. However, the price you pay depends on the rate negotiated by your insurance plan and what portion your insurance plan requires you to contribute towards that amount. Enter your info below to start your estimate.

To calculate an estimate of your cost, you will need two things:

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

More Information

White Rock Medical Center

Cost Estimate

Choose a plan to view the insurance rate estimate.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$365.55

  • Price Negotiated by Insurer

    $59.81

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $3.03

  • Blood Culture

    $4.02

  • CATH L HRT ARTERY/VENTR

    $1,945.35

  • CHED 96365- IV tx, first hour BCE

    $27.00

  • CHED 96366- IV tx, each additional hour BCE

    $13.77

  • CHED 99285 - Level 5 BCE

    $280.00

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $60.57

  • Comprehensive Metabolic Panel

    $4.12

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $188.11

  • DEV CLS VASCULAR MVP VASCADE

    $528.85

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $425.43

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $11.54

  • fentaNYL 50 mcg/mL Inj Soln 10 mL

    $11.52

  • ferrous gluconate 324 mg (38 mg elemental iron) Tab

    $0.72

  • heparin 25,000 units/NaCl 0.45% IV Soln 250 mL Premix

    $11.52

  • iodixanol 320 mg/mL Inj Soln 100 mL

    $19.53

  • Lactated Ringers IV Soln 500 mL

    $11.52

  • Lipase Level

    $2.69

  • midazolam 5 mg/mL Inj Soln 10 mL

    $11.52

  • ROOM/BED: Observation

    $400.00

  • RT CHARGE SpO2 -> Single

    $10.98

  • Sodium Chloride 0.9% IV Soln 1000 mL

    $11.54

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $2.34

  • Troponin-I

    $4.86

  • Urinalysis Microscopic

    $1.24

  • Urine Culture

    $3.16

  • XR Chest

    $25.73

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$320.34

  • Price Negotiated by Insurer

    $105.02

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $7.77

  • Blood Culture

    $10.32

  • CATH L HRT ARTERY/VENTR

    $3,256.70

  • CHED 96365- IV tx, first hour BCE

    $213.67

  • CHED 96366- IV tx, each additional hour BCE

    $47.04

  • CHED 99285 - Level 5 BCE

    $598.24

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $59.26

  • Comprehensive Metabolic Panel

    $10.56

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $239.69

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $548.90

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $47.04

  • Lipase Level

    $6.89

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $72.33

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $6.01

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest

    $87.42

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$320.34

  • Price Negotiated by Insurer

    $105.02

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $7.77

  • Blood Culture

    $10.32

  • CATH L HRT ARTERY/VENTR

    $3,256.70

  • CHED 96365- IV tx, first hour BCE

    $213.67

  • CHED 96366- IV tx, each additional hour BCE

    $47.04

  • CHED 99285 - Level 5 BCE

    $598.24

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $59.26

  • Comprehensive Metabolic Panel

    $10.56

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $239.69

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $548.90

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $47.04

  • Lipase Level

    $6.89

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $72.33

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $6.01

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest

    $87.42

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$240.43

  • Price Negotiated by Insurer

    $184.93

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $116.10

  • Blood Culture

    $117.30

  • CATH L HRT ARTERY/VENTR

    $4,759.42

  • CHED 96365- IV tx, first hour BCE

    $90.00

  • CHED 96366- IV tx, each additional hour BCE

    $45.90

  • CHED 99285 - Level 5 BCE

    $2,640.00

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $201.90

  • Comprehensive Metabolic Panel

    $198.30

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $384.52

  • DEV CLS VASCULAR MVP VASCADE

    $1,762.84

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $1,418.10

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $1.77

  • fentaNYL 50 mcg/mL Inj Soln 10 mL

    $0.57

  • ferrous gluconate 324 mg (38 mg elemental iron) Tab

    $2.40

  • heparin 25,000 units/NaCl 0.45% IV Soln 250 mL Premix

    $0.20

  • iodixanol 320 mg/mL Inj Soln 100 mL

    $0.46

  • Lactated Ringers IV Soln 500 mL

    $8.61

  • Lipase Level

    $82.20

  • midazolam 5 mg/mL Inj Soln 10 mL

    $0.12

  • ROOM/BED: Observation

    $2,745.00

  • RT CHARGE SpO2 -> Single

    $36.60

  • Sodium Chloride 0.9% IV Soln 1000 mL

    $21.61

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $66.00

  • Troponin-I

    $132.60

  • Urinalysis Microscopic

    $56.40

  • Urine Culture

    $42.30

  • XR Chest

    $131.69

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$203.44

  • Price Negotiated by Insurer

    $221.92

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $139.32

  • Blood Culture

    $140.76

  • CATH L HRT ARTERY/VENTR

    $5,699.90

  • CHED 96365- IV tx, first hour BCE

    $108.00

  • CHED 96366- IV tx, each additional hour BCE

    $55.08

  • CHED 99285 - Level 5 BCE

    $3,168.00

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $242.28

  • Comprehensive Metabolic Panel

    $237.96

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $461.42

  • DEV CLS VASCULAR MVP VASCADE

    $2,115.40

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $1,701.72

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $2.12

  • fentaNYL 50 mcg/mL Inj Soln 10 mL

    $0.68

  • ferrous gluconate 324 mg (38 mg elemental iron) Tab

    $2.88

  • heparin 25,000 units/NaCl 0.45% IV Soln 250 mL Premix

    $0.24

  • iodixanol 320 mg/mL Inj Soln 100 mL

    $0.56

  • Lactated Ringers IV Soln 500 mL

    $10.34

  • Lipase Level

    $98.64

  • midazolam 5 mg/mL Inj Soln 10 mL

    $0.14

  • ROOM/BED: Observation

    $3,294.00

  • RT CHARGE SpO2 -> Single

    $43.92

  • Sodium Chloride 0.9% IV Soln 1000 mL

    $25.93

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $79.20

  • Troponin-I

    $159.12

  • Urinalysis Microscopic

    $67.68

  • Urine Culture

    $50.76

  • XR Chest

    $158.02

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$320.34

  • Price Negotiated by Insurer

    $105.02

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $7.77

  • Blood Culture

    $10.32

  • CATH L HRT ARTERY/VENTR

    $3,256.70

  • CHED 96365- IV tx, first hour BCE

    $213.67

  • CHED 96366- IV tx, each additional hour BCE

    $47.04

  • CHED 99285 - Level 5 BCE

    $598.24

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $59.26

  • Comprehensive Metabolic Panel

    $10.56

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $239.69

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $548.90

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $47.04

  • Lipase Level

    $6.89

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $72.33

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $6.01

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest

    $87.42

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$177.66

  • Price Negotiated by Insurer

    $247.70

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $154.80

  • Blood Culture

    $156.40

  • CATH L HRT ARTERY/VENTR

    $7,181.87

  • CHED 96365- IV tx, first hour BCE

    $120.00

  • CHED 96366- IV tx, each additional hour BCE

    $61.20

  • CHED 99285 - Level 5 BCE

    $3,520.00

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $269.20

  • Comprehensive Metabolic Panel

    $264.40

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $515.02

  • DEV CLS VASCULAR MVP VASCADE

    $2,350.45

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $1,890.80

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $2.35

  • fentaNYL 50 mcg/mL Inj Soln 10 mL

    $0.75

  • ferrous gluconate 324 mg (38 mg elemental iron) Tab

    $3.20

  • heparin 25,000 units/NaCl 0.45% IV Soln 250 mL Premix

    $0.27

  • iodixanol 320 mg/mL Inj Soln 100 mL

    $0.62

  • Lactated Ringers IV Soln 500 mL

    $11.46

  • Lipase Level

    $109.60

  • midazolam 5 mg/mL Inj Soln 10 mL

    $0.15

  • ROOM/BED: Observation

    $3,660.00

  • RT CHARGE SpO2 -> Single

    $48.80

  • Sodium Chloride 0.9% IV Soln 1000 mL

    $28.76

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $88.00

  • Troponin-I

    $176.80

  • Urinalysis Microscopic

    $75.20

  • Urine Culture

    $56.40

  • XR Chest

    $176.38

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$136.12

  • Price Negotiated by Insurer

    $289.24

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $263.16

  • Blood Culture

    $265.88

  • CATH L HRT ARTERY/VENTR

    $14,698.20

  • CHED 96365- IV tx, first hour BCE

    $204.00

  • CHED 96366- IV tx, each additional hour BCE

    $104.04

  • CHED 99285 - Level 5 BCE

    $2,067.20

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $457.64

  • Comprehensive Metabolic Panel

    $449.48

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $5,303.32

  • DEV CLS VASCULAR MVP VASCADE

    $3,995.76

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $3,214.36

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $87.16

  • fentaNYL 50 mcg/mL Inj Soln 10 mL

    $87.04

  • ferrous gluconate 324 mg (38 mg elemental iron) Tab

    $5.44

  • heparin 25,000 units/NaCl 0.45% IV Soln 250 mL Premix

    $87.04

  • iodixanol 320 mg/mL Inj Soln 100 mL

    $147.56

  • Lactated Ringers IV Soln 500 mL

    $87.04

  • Lipase Level

    $186.32

  • midazolam 5 mg/mL Inj Soln 10 mL

    $87.04

  • ROOM/BED: Observation

    $74.80

  • RT CHARGE SpO2 -> Single

    $82.96

  • Sodium Chloride 0.9% IV Soln 1000 mL

    $87.16

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $149.60

  • Troponin-I

    $300.56

  • Urinalysis Microscopic

    $127.84

  • Urine Culture

    $95.88

  • XR Chest

    $451.52

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$203.36

  • Price Negotiated by Insurer

    $222.00

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • CATH L HRT ARTERY/VENTR

    $6,884.08

  • CHED 96365- IV tx, first hour BCE

    $451.67

  • CHED 96366- IV tx, each additional hour BCE

    $99.43

  • CHED 99285 - Level 5 BCE

    $2,968.44

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $125.27

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $506.65

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $1,160.29

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $99.43

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $152.89

  • XR Chest

    $184.79

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$119.10

  • Price Negotiated by Insurer

    $306.26

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $278.64

  • Blood Culture

    $281.52

  • CATH L HRT ARTERY/VENTR

    $15,562.80

  • CHED 96365- IV tx, first hour BCE

    $216.00

  • CHED 96366- IV tx, each additional hour BCE

    $110.16

  • CHED 99285 - Level 5 BCE

    $2,188.80

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $484.56

  • Comprehensive Metabolic Panel

    $475.92

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $5,615.28

  • DEV CLS VASCULAR MVP VASCADE

    $4,230.81

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $3,403.44

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $92.28

  • fentaNYL 50 mcg/mL Inj Soln 10 mL

    $92.16

  • ferrous gluconate 324 mg (38 mg elemental iron) Tab

    $5.76

  • heparin 25,000 units/NaCl 0.45% IV Soln 250 mL Premix

    $92.16

  • iodixanol 320 mg/mL Inj Soln 100 mL

    $156.24

  • Lactated Ringers IV Soln 500 mL

    $92.16

  • Lipase Level

    $197.28

  • midazolam 5 mg/mL Inj Soln 10 mL

    $92.16

  • ROOM/BED: Observation

    $79.20

  • RT CHARGE SpO2 -> Single

    $87.84

  • Sodium Chloride 0.9% IV Soln 1000 mL

    $92.28

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $158.40

  • Troponin-I

    $318.24

  • Urinalysis Microscopic

    $135.36

  • Urine Culture

    $101.52

  • XR Chest

    $478.08

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$320.34

  • Price Negotiated by Insurer

    $105.02

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $7.77

  • Blood Culture

    $10.32

  • CATH L HRT ARTERY/VENTR

    $3,256.70

  • CHED 96365- IV tx, first hour BCE

    $213.67

  • CHED 96366- IV tx, each additional hour BCE

    $47.04

  • CHED 99285 - Level 5 BCE

    $598.24

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $59.26

  • Comprehensive Metabolic Panel

    $10.56

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $239.69

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $548.90

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $47.04

  • Lipase Level

    $6.89

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $72.33

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $6.01

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest

    $87.42

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$320.34

  • Price Negotiated by Insurer

    $105.02

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $7.77

  • Blood Culture

    $10.32

  • CATH L HRT ARTERY/VENTR

    $3,256.70

  • CHED 96365- IV tx, first hour BCE

    $213.67

  • CHED 96366- IV tx, each additional hour BCE

    $47.04

  • CHED 99285 - Level 5 BCE

    $598.24

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $59.26

  • Comprehensive Metabolic Panel

    $10.56

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $239.69

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $548.90

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $47.04

  • Lipase Level

    $6.89

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $72.33

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $6.01

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest

    $87.42

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$320.34

  • Price Negotiated by Insurer

    $105.02

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $7.77

  • Blood Culture

    $10.32

  • CATH L HRT ARTERY/VENTR

    $3,256.70

  • CHED 96365- IV tx, first hour BCE

    $213.67

  • CHED 96366- IV tx, each additional hour BCE

    $47.04

  • CHED 99285 - Level 5 BCE

    $598.24

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $59.26

  • Comprehensive Metabolic Panel

    $10.56

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $239.69

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $548.90

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $47.04

  • Lipase Level

    $6.89

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $72.33

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $6.01

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest

    $87.42

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$119.10

  • Price Negotiated by Insurer

    $306.26

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $278.64

  • Blood Culture

    $281.52

  • CATH L HRT ARTERY/VENTR

    $15,562.80

  • CHED 96365- IV tx, first hour BCE

    $216.00

  • CHED 96366- IV tx, each additional hour BCE

    $110.16

  • CHED 99285 - Level 5 BCE

    $2,188.80

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $484.56

  • Comprehensive Metabolic Panel

    $475.92

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $5,615.28

  • DEV CLS VASCULAR MVP VASCADE

    $4,230.81

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $3,403.44

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $92.28

  • fentaNYL 50 mcg/mL Inj Soln 10 mL

    $92.16

  • ferrous gluconate 324 mg (38 mg elemental iron) Tab

    $5.76

  • heparin 25,000 units/NaCl 0.45% IV Soln 250 mL Premix

    $92.16

  • iodixanol 320 mg/mL Inj Soln 100 mL

    $156.24

  • Lactated Ringers IV Soln 500 mL

    $92.16

  • Lipase Level

    $197.28

  • midazolam 5 mg/mL Inj Soln 10 mL

    $92.16

  • ROOM/BED: Observation

    $79.20

  • RT CHARGE SpO2 -> Single

    $87.84

  • Sodium Chloride 0.9% IV Soln 1000 mL

    $92.28

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $158.40

  • Troponin-I

    $318.24

  • Urinalysis Microscopic

    $135.36

  • Urine Culture

    $101.52

  • XR Chest

    $478.08

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$320.34

  • Price Negotiated by Insurer

    $105.02

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $7.77

  • Blood Culture

    $10.32

  • CATH L HRT ARTERY/VENTR

    $3,256.70

  • CHED 96365- IV tx, first hour BCE

    $213.67

  • CHED 96366- IV tx, each additional hour BCE

    $47.04

  • CHED 99285 - Level 5 BCE

    $598.24

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $59.26

  • Comprehensive Metabolic Panel

    $10.56

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $239.69

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $548.90

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $47.04

  • Lipase Level

    $6.89

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $72.33

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $6.01

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest

    $87.42

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$320.34

  • Price Negotiated by Insurer

    $105.02

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $7.77

  • Blood Culture

    $10.32

  • CATH L HRT ARTERY/VENTR

    $3,256.70

  • CHED 96365- IV tx, first hour BCE

    $213.67

  • CHED 96366- IV tx, each additional hour BCE

    $47.04

  • CHED 99285 - Level 5 BCE

    $598.24

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $59.26

  • Comprehensive Metabolic Panel

    $10.56

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $239.69

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $548.90

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $47.04

  • Lipase Level

    $6.89

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $72.33

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $6.01

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest

    $87.42

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$148.88

  • Price Negotiated by Insurer

    $276.48

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $251.55

  • Blood Culture

    $254.15

  • CATH L HRT ARTERY/VENTR

    $14,049.75

  • CHED 96365- IV tx, first hour BCE

    $195.00

  • CHED 96366- IV tx, each additional hour BCE

    $99.45

  • CHED 99285 - Level 5 BCE

    $1,976.00

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $437.45

  • Comprehensive Metabolic Panel

    $429.65

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $5,069.35

  • DEV CLS VASCULAR MVP VASCADE

    $2,938.06

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $3,072.55

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $83.31

  • fentaNYL 50 mcg/mL Inj Soln 10 mL

    $83.20

  • ferrous gluconate 324 mg (38 mg elemental iron) Tab

    $5.20

  • heparin 25,000 units/NaCl 0.45% IV Soln 250 mL Premix

    $83.20

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $10,000.00

  • iodixanol 320 mg/mL Inj Soln 100 mL

    $141.05

  • Lactated Ringers IV Soln 500 mL

    $83.20

  • Lipase Level

    $178.10

  • midazolam 5 mg/mL Inj Soln 10 mL

    $83.20

  • ROOM/BED: Observation

    $71.50

  • RT CHARGE SpO2 -> Single

    $79.30

  • Sodium Chloride 0.9% IV Soln 1000 mL

    $83.31

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $10,000.00

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $143.00

  • Troponin-I

    $287.30

  • Urinalysis Microscopic

    $122.20

  • Urine Culture

    $91.65

  • XR Chest

    $431.60

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$148.88

  • Price Negotiated by Insurer

    $276.48

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $251.55

  • Blood Culture

    $254.15

  • CATH L HRT ARTERY/VENTR

    $14,049.75

  • CHED 96365- IV tx, first hour BCE

    $195.00

  • CHED 96366- IV tx, each additional hour BCE

    $99.45

  • CHED 99285 - Level 5 BCE

    $1,976.00

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $437.45

  • Comprehensive Metabolic Panel

    $429.65

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $5,069.35

  • DEV CLS VASCULAR MVP VASCADE

    $2,938.06

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $3,072.55

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $83.31

  • fentaNYL 50 mcg/mL Inj Soln 10 mL

    $83.20

  • ferrous gluconate 324 mg (38 mg elemental iron) Tab

    $5.20

  • heparin 25,000 units/NaCl 0.45% IV Soln 250 mL Premix

    $83.20

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $10,000.00

  • iodixanol 320 mg/mL Inj Soln 100 mL

    $141.05

  • Lactated Ringers IV Soln 500 mL

    $83.20

  • Lipase Level

    $178.10

  • midazolam 5 mg/mL Inj Soln 10 mL

    $83.20

  • ROOM/BED: Observation

    $71.50

  • RT CHARGE SpO2 -> Single

    $79.30

  • Sodium Chloride 0.9% IV Soln 1000 mL

    $83.31

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $10,000.00

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $143.00

  • Troponin-I

    $287.30

  • Urinalysis Microscopic

    $122.20

  • Urine Culture

    $91.65

  • XR Chest

    $431.60

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$148.88

  • Price Negotiated by Insurer

    $276.48

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $251.55

  • Blood Culture

    $254.15

  • CATH L HRT ARTERY/VENTR

    $14,049.75

  • CHED 96365- IV tx, first hour BCE

    $195.00

  • CHED 96366- IV tx, each additional hour BCE

    $99.45

  • CHED 99285 - Level 5 BCE

    $1,976.00

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $437.45

  • Comprehensive Metabolic Panel

    $429.65

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $5,069.35

  • DEV CLS VASCULAR MVP VASCADE

    $2,938.06

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $3,072.55

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $83.31

  • fentaNYL 50 mcg/mL Inj Soln 10 mL

    $83.20

  • ferrous gluconate 324 mg (38 mg elemental iron) Tab

    $5.20

  • heparin 25,000 units/NaCl 0.45% IV Soln 250 mL Premix

    $83.20

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $10,000.00

  • iodixanol 320 mg/mL Inj Soln 100 mL

    $141.05

  • Lactated Ringers IV Soln 500 mL

    $83.20

  • Lipase Level

    $178.10

  • midazolam 5 mg/mL Inj Soln 10 mL

    $83.20

  • ROOM/BED: Observation

    $71.50

  • RT CHARGE SpO2 -> Single

    $79.30

  • Sodium Chloride 0.9% IV Soln 1000 mL

    $83.31

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $10,000.00

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $143.00

  • Troponin-I

    $287.30

  • Urinalysis Microscopic

    $122.20

  • Urine Culture

    $91.65

  • XR Chest

    $431.60

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$119.10

  • Price Negotiated by Insurer

    $306.26

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $278.64

  • Blood Culture

    $281.52

  • CATH L HRT ARTERY/VENTR

    $15,562.80

  • CHED 96365- IV tx, first hour BCE

    $216.00

  • CHED 96366- IV tx, each additional hour BCE

    $110.16

  • CHED 99285 - Level 5 BCE

    $2,188.80

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $484.56

  • Comprehensive Metabolic Panel

    $475.92

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $5,615.28

  • DEV CLS VASCULAR MVP VASCADE

    $4,230.81

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $3,403.44

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $92.28

  • fentaNYL 50 mcg/mL Inj Soln 10 mL

    $92.16

  • ferrous gluconate 324 mg (38 mg elemental iron) Tab

    $5.76

  • heparin 25,000 units/NaCl 0.45% IV Soln 250 mL Premix

    $92.16

  • iodixanol 320 mg/mL Inj Soln 100 mL

    $156.24

  • Lactated Ringers IV Soln 500 mL

    $92.16

  • Lipase Level

    $197.28

  • midazolam 5 mg/mL Inj Soln 10 mL

    $92.16

  • ROOM/BED: Observation

    $79.20

  • RT CHARGE SpO2 -> Single

    $87.84

  • Sodium Chloride 0.9% IV Soln 1000 mL

    $92.28

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $158.40

  • Troponin-I

    $318.24

  • Urinalysis Microscopic

    $135.36

  • Urine Culture

    $101.52

  • XR Chest

    $478.08

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$267.83

  • Price Negotiated by Insurer

    $157.53

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $9.71

  • Blood Culture

    $12.90

  • CATH L HRT ARTERY/VENTR

    $10,807.50

  • CHED 96365- IV tx, first hour BCE

    $150.00

  • CHED 96366- IV tx, each additional hour BCE

    $76.50

  • CHED 99285 - Level 5 BCE

    $2,900.00

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $336.50

  • Comprehensive Metabolic Panel

    $13.20

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $3,899.50

  • DEV CLS VASCULAR MVP VASCADE

    $2,938.06

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $2,363.50

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $64.08

  • fentaNYL 50 mcg/mL Inj Soln 10 mL

    $64.00

  • ferrous gluconate 324 mg (38 mg elemental iron) Tab

    $4.00

  • heparin 25,000 units/NaCl 0.45% IV Soln 250 mL Premix

    $64.00

  • iodixanol 320 mg/mL Inj Soln 100 mL

    $108.50

  • Lactated Ringers IV Soln 500 mL

    $64.00

  • Lipase Level

    $8.61

  • midazolam 5 mg/mL Inj Soln 10 mL

    $64.00

  • ROOM/BED: Observation

    $55.00

  • RT CHARGE SpO2 -> Single

    $61.00

  • Sodium Chloride 0.9% IV Soln 1000 mL

    $64.08

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $7.51

  • Troponin-I

    $15.59

  • Urinalysis Microscopic

    $3.96

  • Urine Culture

    $10.11

  • XR Chest

    $131.13

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$320.34

  • Price Negotiated by Insurer

    $105.02

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $7.77

  • Blood Culture

    $10.32

  • CATH L HRT ARTERY/VENTR

    $3,256.70

  • CHED 96365- IV tx, first hour BCE

    $213.67

  • CHED 96366- IV tx, each additional hour BCE

    $47.04

  • CHED 99285 - Level 5 BCE

    $598.24

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $59.26

  • Comprehensive Metabolic Panel

    $10.56

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $239.69

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $548.90

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $47.04

  • Lipase Level

    $6.89

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $72.33

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $6.01

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest

    $87.42

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$119.10

  • Price Negotiated by Insurer

    $306.26

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $278.64

  • Blood Culture

    $281.52

  • CATH L HRT ARTERY/VENTR

    $15,562.80

  • CHED 96365- IV tx, first hour BCE

    $216.00

  • CHED 96366- IV tx, each additional hour BCE

    $110.16

  • CHED 99285 - Level 5 BCE

    $2,188.80

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $484.56

  • Comprehensive Metabolic Panel

    $475.92

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $5,615.28

  • DEV CLS VASCULAR MVP VASCADE

    $4,230.81

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $3,403.44

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $92.28

  • fentaNYL 50 mcg/mL Inj Soln 10 mL

    $92.16

  • ferrous gluconate 324 mg (38 mg elemental iron) Tab

    $5.76

  • heparin 25,000 units/NaCl 0.45% IV Soln 250 mL Premix

    $92.16

  • iodixanol 320 mg/mL Inj Soln 100 mL

    $156.24

  • Lactated Ringers IV Soln 500 mL

    $92.16

  • Lipase Level

    $197.28

  • midazolam 5 mg/mL Inj Soln 10 mL

    $92.16

  • ROOM/BED: Observation

    $79.20

  • RT CHARGE SpO2 -> Single

    $87.84

  • Sodium Chloride 0.9% IV Soln 1000 mL

    $92.28

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $158.40

  • Troponin-I

    $318.24

  • Urinalysis Microscopic

    $135.36

  • Urine Culture

    $101.52

  • XR Chest

    $478.08

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$320.34

  • Price Negotiated by Insurer

    $105.02

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $7.77

  • Blood Culture

    $10.32

  • CATH L HRT ARTERY/VENTR

    $3,256.70

  • CHED 96365- IV tx, first hour BCE

    $213.67

  • CHED 96366- IV tx, each additional hour BCE

    $47.04

  • CHED 99285 - Level 5 BCE

    $598.24

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $59.26

  • Comprehensive Metabolic Panel

    $10.56

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $239.69

  • DEV CLS VASCULAR MVP VASCADE

    $799.15

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $548.90

  • enoxaparin 30 mg/0.3 mL Inj Soln 0.3 mL

    $17.43

  • fentaNYL 50 mcg/mL Inj Soln 10 mL

    $17.41

  • ferrous gluconate 324 mg (38 mg elemental iron) Tab

    $1.09

  • heparin 25,000 units/NaCl 0.45% IV Soln 250 mL Premix

    $17.41

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $47.04

  • iodixanol 320 mg/mL Inj Soln 100 mL

    $29.51

  • Lactated Ringers IV Soln 500 mL

    $17.41

  • Lipase Level

    $6.89

  • midazolam 5 mg/mL Inj Soln 10 mL

    $17.41

  • ROOM/BED: Observation

    $14.96

  • RT CHARGE SpO2 -> Single

    $16.59

  • Sodium Chloride 0.9% IV Soln 1000 mL

    $17.43

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $72.33

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $6.01

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest

    $87.42

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$320.34

  • Price Negotiated by Insurer

    $105.02

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $7.77

  • Blood Culture

    $10.32

  • CATH L HRT ARTERY/VENTR

    $3,256.70

  • CHED 96365- IV tx, first hour BCE

    $213.67

  • CHED 96366- IV tx, each additional hour BCE

    $47.04

  • CHED 99285 - Level 5 BCE

    $598.24

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $59.26

  • Comprehensive Metabolic Panel

    $10.56

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $239.69

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $548.90

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $47.04

  • Lipase Level

    $6.89

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $72.33

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $6.01

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest

    $87.42

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$320.34

  • Price Negotiated by Insurer

    $105.02

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $7.77

  • Blood Culture

    $10.32

  • CATH L HRT ARTERY/VENTR

    $3,256.70

  • CHED 96365- IV tx, first hour BCE

    $213.67

  • CHED 96366- IV tx, each additional hour BCE

    $47.04

  • CHED 99285 - Level 5 BCE

    $598.24

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $59.26

  • Comprehensive Metabolic Panel

    $10.56

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $239.69

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $548.90

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $47.04

  • Lipase Level

    $6.89

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $72.33

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $6.01

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest

    $87.42

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$320.34

  • Price Negotiated by Insurer

    $105.02

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $7.77

  • Blood Culture

    $10.32

  • CATH L HRT ARTERY/VENTR

    $3,256.70

  • CHED 96365- IV tx, first hour BCE

    $213.67

  • CHED 96366- IV tx, each additional hour BCE

    $47.04

  • CHED 99285 - Level 5 BCE

    $598.24

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $59.26

  • Comprehensive Metabolic Panel

    $10.56

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $239.69

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $548.90

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $47.04

  • Lipase Level

    $6.89

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $72.33

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $6.01

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest

    $87.42

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$320.34

  • Price Negotiated by Insurer

    $105.02

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $7.77

  • Blood Culture

    $10.32

  • CATH L HRT ARTERY/VENTR

    $3,256.70

  • CHED 96365- IV tx, first hour BCE

    $213.67

  • CHED 96366- IV tx, each additional hour BCE

    $47.04

  • CHED 99285 - Level 5 BCE

    $598.24

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $59.26

  • Comprehensive Metabolic Panel

    $10.56

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $239.69

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $548.90

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $47.04

  • Lipase Level

    $6.89

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $72.33

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $6.01

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest

    $87.42

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.

Cost Estimate

  • Total estimated charges

    $425.36

  • Insurance Discount

    -$320.34

  • Price Negotiated by Insurer

    $105.02

  • Deductible Applied

    -

  • Copay

    -

  • Coinsurance

    -

  • Your insurance company will pay

    -

  • You will owe (Estimate)

    -

Associated Charges

Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.

  • 85025 CBC W/AUTOMATED DIFFERENTIAL

    $7.77

  • Blood Culture

    $10.32

  • CATH L HRT ARTERY/VENTR

    $3,256.70

  • CHED 96365- IV tx, first hour BCE

    $213.67

  • CHED 96366- IV tx, each additional hour BCE

    $47.04

  • CHED 99285 - Level 5 BCE

    $598.24

  • CHED Routine ECG 12 lead/15 lead tracing only BCE

    $59.26

  • Comprehensive Metabolic Panel

    $10.56

  • CT Abd/Pelvis w/o IV and Oral Contrast

    $239.69

  • EKG Charges - EKG -> Echo2D Spectr/Color FLO 93306

    $548.90

  • Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima

    $47.04

  • Lipase Level

    $6.89

  • Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intr

    $72.33

  • Thromboplastin time, partial (PTT); plasma or whole blood

    $6.01

  • Troponin-I

    $12.47

  • Urinalysis Microscopic

    $3.17

  • Urine Culture

    $8.09

  • XR Chest

    $87.42

This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.

To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.