CPT 70547
The standard charge for MRA scan of neck without contrast is $5,737.00. 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
$5,737.00Insurance Discount
-$5,514.46Price Negotiated by Insurer
$222.54Deductible 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
$3.03albuterol-ipratropium 2.5 mg-0.5 mg/3 mL Inh Soln 3 mL
$0.69Basic Metabolic Panel
$3.30CHED 96374- IV Injection, single/initial BCE
$32.40CHED 99285 - Level 5 BCE
$280.00CHED PRESSD NONPRESSD INHAL TRMENT BCE
$34.70CHED Routine ECG 12 lead/15 lead tracing only BCE
$60.57Comprehensive Metabolic Panel
$4.12Creatine Kinase,Total SO
$2.54CT Brain Stroke Protocol w/o Contrast
$104.75ferrous gluconate 324 mg (38 mg elemental iron) Tab
$0.72Free T4 Level
$3.52Hemoglobin A1C
$3.79MRA Brain/Head w/o Contrast
$222.20MRI Brain Stroke Protocol w/o Contrast
$202.15NT-proBNP SO
$15.31ondansetron 2 mg/mL Inj Soln 2 mL
$11.52ROOM/BED: Observation
$400.00sterile water Inj Soln 10 mL
$11.54Thyroid Stimulating Hormone
$6.55Troponin-I
$4.86Urinalysis without Microscopic
$0.88US Carotid Duplex Bilateral
$298.53WRNR PT Evaluation Low Complexity BCE
$80.00XR 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
$5,737.00Insurance Discount
-$5,497.31Price Negotiated by Insurer
$239.69Deductible 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 PRESSD NONPRESSD INHAL TRMENT BCE
$219.97CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Creatine Kinase,Total SO
$6.51CT Brain Stroke Protocol w/o Contrast
$105.02Free T4 Level
$9.02Hemoglobin A1C
$9.71Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$47.04MRA Brain/Head w/o Contrast
$239.69MRI Brain Stroke Protocol w/o Contrast
$239.69NT-proBNP SO
$39.26Thyroid Stimulating Hormone
$16.80Troponin-I
$12.47Urinalysis without Microscopic
$2.25US Carotid Duplex Bilateral
$239.69XR 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
$5,737.00Insurance Discount
-$5,497.31Price Negotiated by Insurer
$239.69Deductible 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 PRESSD NONPRESSD INHAL TRMENT BCE
$219.97CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Creatine Kinase,Total SO
$6.51CT Brain Stroke Protocol w/o Contrast
$105.02Free T4 Level
$9.02Hemoglobin A1C
$9.71Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$47.04MRA Brain/Head w/o Contrast
$239.69MRI Brain Stroke Protocol w/o Contrast
$239.69NT-proBNP SO
$39.26Thyroid Stimulating Hormone
$16.80Troponin-I
$12.47Urinalysis without Microscopic
$2.25US Carotid Duplex Bilateral
$239.69XR 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
$5,737.00Insurance Discount
-$5,352.48Price Negotiated by Insurer
$384.52Deductible 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
$116.10albuterol-ipratropium 2.5 mg-0.5 mg/3 mL Inh Soln 3 mL
$0.35Basic Metabolic Panel
$148.80CHED 96374- IV Injection, single/initial BCE
$108.00CHED 99285 - Level 5 BCE
$2,640.00CHED PRESSD NONPRESSD INHAL TRMENT BCE
$115.66CHED Routine ECG 12 lead/15 lead tracing only BCE
$201.90Comprehensive Metabolic Panel
$198.30Creatine Kinase,Total SO
$83.10CT Brain Stroke Protocol w/o Contrast
$184.93ferrous gluconate 324 mg (38 mg elemental iron) Tab
$2.40Free T4 Level
$94.80Hemoglobin A1C
$83.70MRA Brain/Head w/o Contrast
$384.52MRI Brain Stroke Protocol w/o Contrast
$384.52NT-proBNP SO
$149.70ondansetron 2 mg/mL Inj Soln 2 mL
$0.86ROOM/BED: Observation
$2,745.00sterile water Inj Soln 10 mL
$0.64Thyroid Stimulating Hormone
$150.60Troponin-I
$132.60Urinalysis without Microscopic
$36.60US Carotid Duplex Bilateral
$995.10WRNR PT Evaluation Low Complexity BCE
$38.10XR 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
$5,737.00Insurance Discount
-$5,275.58Price Negotiated by Insurer
$461.42Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
83735 MAGNESIUM
$84.2485025 CBC W/AUTOMATED DIFFERENTIAL
$139.32albuterol-ipratropium 2.5 mg-0.5 mg/3 mL Inh Soln 3 mL
$0.42Basic Metabolic Panel
$178.56CHED 96374- IV Injection, single/initial BCE
$129.60CHED 99285 - Level 5 BCE
$3,168.00CHED PRESSD NONPRESSD INHAL TRMENT BCE
$138.79CHED Routine ECG 12 lead/15 lead tracing only BCE
$242.28Comprehensive Metabolic Panel
$237.96Creatine Kinase,Total SO
$99.72CT Brain Stroke Protocol w/o Contrast
$221.92ferrous gluconate 324 mg (38 mg elemental iron) Tab
$2.88Free T4 Level
$113.76Hemoglobin A1C
$100.44MRA Brain/Head w/o Contrast
$461.42MRI Brain Stroke Protocol w/o Contrast
$461.42NT-proBNP SO
$179.64ondansetron 2 mg/mL Inj Soln 2 mL
$1.03ROOM/BED: Observation
$3,294.00sterile water Inj Soln 10 mL
$0.77Thyroid Stimulating Hormone
$180.72Troponin-I
$159.12Urinalysis without Microscopic
$43.92US Carotid Duplex Bilateral
$1,194.12WRNR PT Evaluation Low Complexity BCE
$45.72XR 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
$5,737.00Insurance Discount
-$5,497.31Price Negotiated by Insurer
$239.69Deductible 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 PRESSD NONPRESSD INHAL TRMENT BCE
$219.97CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Creatine Kinase,Total SO
$6.51CT Brain Stroke Protocol w/o Contrast
$105.02Free T4 Level
$9.02Hemoglobin A1C
$9.71Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$47.04MRA Brain/Head w/o Contrast
$239.69MRI Brain Stroke Protocol w/o Contrast
$239.69NT-proBNP SO
$39.26Thyroid Stimulating Hormone
$16.80Troponin-I
$12.47Urinalysis without Microscopic
$2.25US Carotid Duplex Bilateral
$239.69XR 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
$5,737.00Insurance Discount
-$5,221.98Price Negotiated by Insurer
$515.02Deductible 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
$154.80albuterol-ipratropium 2.5 mg-0.5 mg/3 mL Inh Soln 3 mL
$0.46Basic Metabolic Panel
$198.40CHED 96374- IV Injection, single/initial BCE
$144.00CHED 99285 - Level 5 BCE
$3,520.00CHED PRESSD NONPRESSD INHAL TRMENT BCE
$154.21CHED Routine ECG 12 lead/15 lead tracing only BCE
$269.20Comprehensive Metabolic Panel
$264.40Creatine Kinase,Total SO
$110.80CT Brain Stroke Protocol w/o Contrast
$247.70ferrous gluconate 324 mg (38 mg elemental iron) Tab
$3.20Free T4 Level
$126.40Hemoglobin A1C
$111.60MRA Brain/Head w/o Contrast
$515.02MRI Brain Stroke Protocol w/o Contrast
$515.02NT-proBNP SO
$199.60ondansetron 2 mg/mL Inj Soln 2 mL
$1.14ROOM/BED: Observation
$3,660.00sterile water Inj Soln 10 mL
$0.85Thyroid Stimulating Hormone
$200.80Troponin-I
$176.80Urinalysis without Microscopic
$48.80US Carotid Duplex Bilateral
$1,326.80WRNR PT Evaluation Low Complexity BCE
$50.80XR 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
$5,737.00Insurance Discount
-$1,835.84Price Negotiated by Insurer
$3,901.16Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
83735 MAGNESIUM
$159.1285025 CBC W/AUTOMATED DIFFERENTIAL
$263.16albuterol-ipratropium 2.5 mg-0.5 mg/3 mL Inh Soln 3 mL
$5.20Basic Metabolic Panel
$337.28CHED 96374- IV Injection, single/initial BCE
$244.80CHED 99285 - Level 5 BCE
$2,067.20CHED PRESSD NONPRESSD INHAL TRMENT BCE
$262.16CHED Routine ECG 12 lead/15 lead tracing only BCE
$457.64Comprehensive Metabolic Panel
$449.48Creatine Kinase,Total SO
$188.36CT Brain Stroke Protocol w/o Contrast
$3,056.60ferrous gluconate 324 mg (38 mg elemental iron) Tab
$5.44Free T4 Level
$214.88Hemoglobin A1C
$189.72MRA Brain/Head w/o Contrast
$3,901.16MRI Brain Stroke Protocol w/o Contrast
$3,417.68NT-proBNP SO
$339.32ondansetron 2 mg/mL Inj Soln 2 mL
$87.04ROOM/BED: Observation
$74.80sterile water Inj Soln 10 mL
$87.16Thyroid Stimulating Hormone
$341.36Troponin-I
$300.56Urinalysis without Microscopic
$82.96US Carotid Duplex Bilateral
$2,255.56WRNR PT Evaluation Low Complexity BCE
$86.36XR 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
$5,737.00Insurance Discount
-$5,230.35Price Negotiated by Insurer
$506.65Deductible 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 PRESSD NONPRESSD INHAL TRMENT BCE
$464.99CHED Routine ECG 12 lead/15 lead tracing only BCE
$125.27CT Brain Stroke Protocol w/o Contrast
$222.00Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$99.43MRA Brain/Head w/o Contrast
$506.65MRI Brain Stroke Protocol w/o Contrast
$506.65US Carotid Duplex Bilateral
$506.65WRNR PT Evaluation Low Complexity BCE
$200.00XR 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
$5,737.00Insurance Discount
-$1,606.36Price Negotiated by Insurer
$4,130.64Deductible 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
$278.64albuterol-ipratropium 2.5 mg-0.5 mg/3 mL Inh Soln 3 mL
$5.51Basic Metabolic Panel
$357.12CHED 96374- IV Injection, single/initial BCE
$259.20CHED 99285 - Level 5 BCE
$2,188.80CHED PRESSD NONPRESSD INHAL TRMENT BCE
$277.58CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56Comprehensive Metabolic Panel
$475.92Creatine Kinase,Total SO
$199.44CT Brain Stroke Protocol w/o Contrast
$3,236.40ferrous gluconate 324 mg (38 mg elemental iron) Tab
$5.76Free T4 Level
$227.52Hemoglobin A1C
$200.88MRA Brain/Head w/o Contrast
$4,130.64MRI Brain Stroke Protocol w/o Contrast
$3,618.72NT-proBNP SO
$359.28ondansetron 2 mg/mL Inj Soln 2 mL
$92.16ROOM/BED: Observation
$79.20sterile water Inj Soln 10 mL
$92.28Thyroid Stimulating Hormone
$361.44Troponin-I
$318.24Urinalysis without Microscopic
$87.84US Carotid Duplex Bilateral
$2,388.24WRNR PT Evaluation Low Complexity BCE
$91.44XR 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
$5,737.00Insurance Discount
-$5,497.31Price Negotiated by Insurer
$239.69Deductible 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 PRESSD NONPRESSD INHAL TRMENT BCE
$219.97CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Creatine Kinase,Total SO
$6.51CT Brain Stroke Protocol w/o Contrast
$105.02Free T4 Level
$9.02Hemoglobin A1C
$9.71Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$47.04MRA Brain/Head w/o Contrast
$239.69MRI Brain Stroke Protocol w/o Contrast
$239.69NT-proBNP SO
$39.26Thyroid Stimulating Hormone
$16.80Troponin-I
$12.47Urinalysis without Microscopic
$2.25US Carotid Duplex Bilateral
$239.69XR 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
$5,737.00Insurance Discount
-$5,497.31Price Negotiated by Insurer
$239.69Deductible 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 PRESSD NONPRESSD INHAL TRMENT BCE
$219.97CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Creatine Kinase,Total SO
$6.51CT Brain Stroke Protocol w/o Contrast
$105.02Free T4 Level
$9.02Hemoglobin A1C
$9.71Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$47.04MRA Brain/Head w/o Contrast
$239.69MRI Brain Stroke Protocol w/o Contrast
$239.69NT-proBNP SO
$39.26Thyroid Stimulating Hormone
$16.80Troponin-I
$12.47Urinalysis without Microscopic
$2.25US Carotid Duplex Bilateral
$239.69XR 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
$5,737.00Insurance Discount
-$5,497.31Price Negotiated by Insurer
$239.69Deductible 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 PRESSD NONPRESSD INHAL TRMENT BCE
$219.97CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Creatine Kinase,Total SO
$6.51CT Brain Stroke Protocol w/o Contrast
$105.02Free T4 Level
$9.02Hemoglobin A1C
$9.71Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$47.04MRA Brain/Head w/o Contrast
$239.69MRI Brain Stroke Protocol w/o Contrast
$239.69NT-proBNP SO
$39.26Thyroid Stimulating Hormone
$16.80Troponin-I
$12.47Urinalysis without Microscopic
$2.25US Carotid Duplex Bilateral
$239.69XR 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
$5,737.00Insurance Discount
-$1,606.36Price Negotiated by Insurer
$4,130.64Deductible 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
$278.64albuterol-ipratropium 2.5 mg-0.5 mg/3 mL Inh Soln 3 mL
$5.51Basic Metabolic Panel
$357.12CHED 96374- IV Injection, single/initial BCE
$259.20CHED 99285 - Level 5 BCE
$2,188.80CHED PRESSD NONPRESSD INHAL TRMENT BCE
$277.58CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56Comprehensive Metabolic Panel
$475.92Creatine Kinase,Total SO
$199.44CT Brain Stroke Protocol w/o Contrast
$3,236.40ferrous gluconate 324 mg (38 mg elemental iron) Tab
$5.76Free T4 Level
$227.52Hemoglobin A1C
$200.88MRA Brain/Head w/o Contrast
$4,130.64MRI Brain Stroke Protocol w/o Contrast
$3,618.72NT-proBNP SO
$359.28ondansetron 2 mg/mL Inj Soln 2 mL
$92.16ROOM/BED: Observation
$79.20sterile water Inj Soln 10 mL
$92.28Thyroid Stimulating Hormone
$361.44Troponin-I
$318.24Urinalysis without Microscopic
$87.84US Carotid Duplex Bilateral
$2,388.24WRNR PT Evaluation Low Complexity BCE
$91.44XR 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
$5,737.00Insurance Discount
-$5,497.31Price Negotiated by Insurer
$239.69Deductible 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 PRESSD NONPRESSD INHAL TRMENT BCE
$219.97CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Creatine Kinase,Total SO
$6.51CT Brain Stroke Protocol w/o Contrast
$105.02Free T4 Level
$9.02Hemoglobin A1C
$9.71Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$47.04MRA Brain/Head w/o Contrast
$239.69MRI Brain Stroke Protocol w/o Contrast
$239.69NT-proBNP SO
$39.26Thyroid Stimulating Hormone
$16.80Troponin-I
$12.47Urinalysis without Microscopic
$2.25US Carotid Duplex Bilateral
$239.69XR 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
$5,737.00Insurance Discount
-$5,497.31Price Negotiated by Insurer
$239.69Deductible 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 PRESSD NONPRESSD INHAL TRMENT BCE
$219.97CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Creatine Kinase,Total SO
$6.51CT Brain Stroke Protocol w/o Contrast
$105.02Free T4 Level
$9.02Hemoglobin A1C
$9.71Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$47.04MRA Brain/Head w/o Contrast
$239.69MRI Brain Stroke Protocol w/o Contrast
$239.69NT-proBNP SO
$39.26Thyroid Stimulating Hormone
$16.80Troponin-I
$12.47Urinalysis without Microscopic
$2.25US Carotid Duplex Bilateral
$239.69XR 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
$5,737.00Insurance Discount
-$2,007.95Price Negotiated by Insurer
$3,729.05Deductible 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
$152.1085025 CBC W/AUTOMATED DIFFERENTIAL
$251.55albuterol-ipratropium 2.5 mg-0.5 mg/3 mL Inh Soln 3 mL
$4.97Basic Metabolic Panel
$322.40CHED 96374- IV Injection, single/initial BCE
$234.00CHED 99285 - Level 5 BCE
$1,976.00CHED PRESSD NONPRESSD INHAL TRMENT BCE
$250.59CHED Routine ECG 12 lead/15 lead tracing only BCE
$437.45Comprehensive Metabolic Panel
$429.65Creatine Kinase,Total SO
$180.05CT Brain Stroke Protocol w/o Contrast
$2,921.75ferrous gluconate 324 mg (38 mg elemental iron) Tab
$5.20Free T4 Level
$205.40Hemoglobin A1C
$181.35Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$10,000.00MRA Brain/Head w/o Contrast
$3,729.05MRI Brain Stroke Protocol w/o Contrast
$3,266.90NT-proBNP SO
$324.35ondansetron 2 mg/mL Inj Soln 2 mL
$83.20ROOM/BED: Observation
$71.50sterile water Inj Soln 10 mL
$83.31Thyroid Stimulating Hormone
$326.30Troponin-I
$287.30Urinalysis without Microscopic
$79.30US Carotid Duplex Bilateral
$2,156.05WRNR PT Evaluation Low Complexity BCE
$82.55XR 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
$5,737.00Insurance Discount
-$2,007.95Price Negotiated by Insurer
$3,729.05Deductible 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
$152.1085025 CBC W/AUTOMATED DIFFERENTIAL
$251.55albuterol-ipratropium 2.5 mg-0.5 mg/3 mL Inh Soln 3 mL
$4.97Basic Metabolic Panel
$322.40CHED 96374- IV Injection, single/initial BCE
$234.00CHED 99285 - Level 5 BCE
$1,976.00CHED PRESSD NONPRESSD INHAL TRMENT BCE
$250.59CHED Routine ECG 12 lead/15 lead tracing only BCE
$437.45Comprehensive Metabolic Panel
$429.65Creatine Kinase,Total SO
$180.05CT Brain Stroke Protocol w/o Contrast
$2,921.75ferrous gluconate 324 mg (38 mg elemental iron) Tab
$5.20Free T4 Level
$205.40Hemoglobin A1C
$181.35Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$10,000.00MRA Brain/Head w/o Contrast
$3,729.05MRI Brain Stroke Protocol w/o Contrast
$3,266.90NT-proBNP SO
$324.35ondansetron 2 mg/mL Inj Soln 2 mL
$83.20ROOM/BED: Observation
$71.50sterile water Inj Soln 10 mL
$83.31Thyroid Stimulating Hormone
$326.30Troponin-I
$287.30Urinalysis without Microscopic
$79.30US Carotid Duplex Bilateral
$2,156.05WRNR PT Evaluation Low Complexity BCE
$82.55XR 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
$5,737.00Insurance Discount
-$2,007.95Price Negotiated by Insurer
$3,729.05Deductible 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
$152.1085025 CBC W/AUTOMATED DIFFERENTIAL
$251.55albuterol-ipratropium 2.5 mg-0.5 mg/3 mL Inh Soln 3 mL
$4.97Basic Metabolic Panel
$322.40CHED 96374- IV Injection, single/initial BCE
$234.00CHED 99285 - Level 5 BCE
$1,976.00CHED PRESSD NONPRESSD INHAL TRMENT BCE
$250.59CHED Routine ECG 12 lead/15 lead tracing only BCE
$437.45Comprehensive Metabolic Panel
$429.65Creatine Kinase,Total SO
$180.05CT Brain Stroke Protocol w/o Contrast
$2,921.75ferrous gluconate 324 mg (38 mg elemental iron) Tab
$5.20Free T4 Level
$205.40Hemoglobin A1C
$181.35Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$10,000.00MRA Brain/Head w/o Contrast
$3,729.05MRI Brain Stroke Protocol w/o Contrast
$3,266.90NT-proBNP SO
$324.35ondansetron 2 mg/mL Inj Soln 2 mL
$83.20ROOM/BED: Observation
$71.50sterile water Inj Soln 10 mL
$83.31Thyroid Stimulating Hormone
$326.30Troponin-I
$287.30Urinalysis without Microscopic
$79.30US Carotid Duplex Bilateral
$2,156.05WRNR PT Evaluation Low Complexity BCE
$82.55XR 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
$5,737.00Insurance Discount
-$1,606.36Price Negotiated by Insurer
$4,130.64Deductible 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
$278.64albuterol-ipratropium 2.5 mg-0.5 mg/3 mL Inh Soln 3 mL
$5.51Basic Metabolic Panel
$357.12CHED 96374- IV Injection, single/initial BCE
$259.20CHED 99285 - Level 5 BCE
$2,188.80CHED PRESSD NONPRESSD INHAL TRMENT BCE
$277.58CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56Comprehensive Metabolic Panel
$475.92Creatine Kinase,Total SO
$199.44CT Brain Stroke Protocol w/o Contrast
$3,236.40ferrous gluconate 324 mg (38 mg elemental iron) Tab
$5.76Free T4 Level
$227.52Hemoglobin A1C
$200.88MRA Brain/Head w/o Contrast
$4,130.64MRI Brain Stroke Protocol w/o Contrast
$3,618.72NT-proBNP SO
$359.28ondansetron 2 mg/mL Inj Soln 2 mL
$92.16ROOM/BED: Observation
$79.20sterile water Inj Soln 10 mL
$92.28Thyroid Stimulating Hormone
$361.44Troponin-I
$318.24Urinalysis without Microscopic
$87.84US Carotid Duplex Bilateral
$2,388.24WRNR PT Evaluation Low Complexity BCE
$91.44XR 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
$5,737.00Insurance Discount
-$2,868.50Price Negotiated by Insurer
$2,868.50Deductible 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
$9.71albuterol-ipratropium 2.5 mg-0.5 mg/3 mL Inh Soln 3 mL
$3.83Basic Metabolic Panel
$10.57CHED 96374- IV Injection, single/initial BCE
$180.00CHED 99285 - Level 5 BCE
$2,900.00CHED PRESSD NONPRESSD INHAL TRMENT BCE
$192.76CHED Routine ECG 12 lead/15 lead tracing only BCE
$336.50Comprehensive Metabolic Panel
$13.20Creatine Kinase,Total SO
$8.14CT Brain Stroke Protocol w/o Contrast
$2,247.50ferrous gluconate 324 mg (38 mg elemental iron) Tab
$4.00Free T4 Level
$11.28Hemoglobin A1C
$12.14MRA Brain/Head w/o Contrast
$2,868.50MRI Brain Stroke Protocol w/o Contrast
$2,513.00NT-proBNP SO
$49.08ondansetron 2 mg/mL Inj Soln 2 mL
$64.00ROOM/BED: Observation
$55.00sterile water Inj Soln 10 mL
$64.08Thyroid Stimulating Hormone
$21.00Troponin-I
$15.59Urinalysis without Microscopic
$2.81US Carotid Duplex Bilateral
$1,658.50WRNR PT Evaluation Low Complexity BCE
$180.00XR 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
$5,737.00Insurance Discount
-$5,497.31Price Negotiated by Insurer
$239.69Deductible 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 PRESSD NONPRESSD INHAL TRMENT BCE
$219.97CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Creatine Kinase,Total SO
$6.51CT Brain Stroke Protocol w/o Contrast
$105.02Free T4 Level
$9.02Hemoglobin A1C
$9.71Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$47.04MRA Brain/Head w/o Contrast
$239.69MRI Brain Stroke Protocol w/o Contrast
$239.69NT-proBNP SO
$39.26Thyroid Stimulating Hormone
$16.80Troponin-I
$12.47Urinalysis without Microscopic
$2.25US Carotid Duplex Bilateral
$239.69XR 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
$5,737.00Insurance Discount
-$1,606.36Price Negotiated by Insurer
$4,130.64Deductible 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
$278.64albuterol-ipratropium 2.5 mg-0.5 mg/3 mL Inh Soln 3 mL
$5.51Basic Metabolic Panel
$357.12CHED 96374- IV Injection, single/initial BCE
$259.20CHED 99285 - Level 5 BCE
$2,188.80CHED PRESSD NONPRESSD INHAL TRMENT BCE
$277.58CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56Comprehensive Metabolic Panel
$475.92Creatine Kinase,Total SO
$199.44CT Brain Stroke Protocol w/o Contrast
$3,236.40ferrous gluconate 324 mg (38 mg elemental iron) Tab
$5.76Free T4 Level
$227.52Hemoglobin A1C
$200.88MRA Brain/Head w/o Contrast
$4,130.64MRI Brain Stroke Protocol w/o Contrast
$3,618.72NT-proBNP SO
$359.28ondansetron 2 mg/mL Inj Soln 2 mL
$92.16ROOM/BED: Observation
$79.20sterile water Inj Soln 10 mL
$92.28Thyroid Stimulating Hormone
$361.44Troponin-I
$318.24Urinalysis without Microscopic
$87.84US Carotid Duplex Bilateral
$2,388.24WRNR PT Evaluation Low Complexity BCE
$91.44XR 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
$5,737.00Insurance Discount
-$5,497.31Price Negotiated by Insurer
$239.69Deductible 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
$7.77albuterol-ipratropium 2.5 mg-0.5 mg/3 mL Inh Soln 3 mL
$1.04Basic Metabolic Panel
$8.46CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99285 - Level 5 BCE
$598.24CHED PRESSD NONPRESSD INHAL TRMENT BCE
$219.97CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Creatine Kinase,Total SO
$6.51CT Brain Stroke Protocol w/o Contrast
$105.02ferrous gluconate 324 mg (38 mg elemental iron) Tab
$1.09Free T4 Level
$9.02Hemoglobin A1C
$9.71Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$47.04MRA Brain/Head w/o Contrast
$239.69MRI Brain Stroke Protocol w/o Contrast
$239.69NT-proBNP SO
$39.26ondansetron 2 mg/mL Inj Soln 2 mL
$17.41ROOM/BED: Observation
$14.96sterile water Inj Soln 10 mL
$17.43Thyroid Stimulating Hormone
$16.80Troponin-I
$12.47Urinalysis without Microscopic
$2.25US Carotid Duplex Bilateral
$239.69WRNR PT Evaluation Low Complexity BCE
$17.27XR 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
$5,737.00Insurance Discount
-$5,497.31Price Negotiated by Insurer
$239.69Deductible 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 PRESSD NONPRESSD INHAL TRMENT BCE
$219.97CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Creatine Kinase,Total SO
$6.51CT Brain Stroke Protocol w/o Contrast
$105.02Free T4 Level
$9.02Hemoglobin A1C
$9.71Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$47.04MRA Brain/Head w/o Contrast
$239.69MRI Brain Stroke Protocol w/o Contrast
$239.69NT-proBNP SO
$39.26Thyroid Stimulating Hormone
$16.80Troponin-I
$12.47Urinalysis without Microscopic
$2.25US Carotid Duplex Bilateral
$239.69XR 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
$5,737.00Insurance Discount
-$5,497.31Price Negotiated by Insurer
$239.69Deductible 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 PRESSD NONPRESSD INHAL TRMENT BCE
$219.97CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Creatine Kinase,Total SO
$6.51CT Brain Stroke Protocol w/o Contrast
$105.02Free T4 Level
$9.02Hemoglobin A1C
$9.71Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$47.04MRA Brain/Head w/o Contrast
$239.69MRI Brain Stroke Protocol w/o Contrast
$239.69NT-proBNP SO
$39.26Thyroid Stimulating Hormone
$16.80Troponin-I
$12.47Urinalysis without Microscopic
$2.25US Carotid Duplex Bilateral
$239.69XR 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
$5,737.00Insurance Discount
-$5,497.31Price Negotiated by Insurer
$239.69Deductible 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 PRESSD NONPRESSD INHAL TRMENT BCE
$219.97CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Creatine Kinase,Total SO
$6.51CT Brain Stroke Protocol w/o Contrast
$105.02Free T4 Level
$9.02Hemoglobin A1C
$9.71Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$47.04MRA Brain/Head w/o Contrast
$239.69MRI Brain Stroke Protocol w/o Contrast
$239.69NT-proBNP SO
$39.26Thyroid Stimulating Hormone
$16.80Troponin-I
$12.47Urinalysis without Microscopic
$2.25US Carotid Duplex Bilateral
$239.69XR 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
$5,737.00Insurance Discount
-$5,497.31Price Negotiated by Insurer
$239.69Deductible 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 PRESSD NONPRESSD INHAL TRMENT BCE
$219.97CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Creatine Kinase,Total SO
$6.51CT Brain Stroke Protocol w/o Contrast
$105.02Free T4 Level
$9.02Hemoglobin A1C
$9.71Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$47.04MRA Brain/Head w/o Contrast
$239.69MRI Brain Stroke Protocol w/o Contrast
$239.69NT-proBNP SO
$39.26Thyroid Stimulating Hormone
$16.80Troponin-I
$12.47Urinalysis without Microscopic
$2.25US Carotid Duplex Bilateral
$239.69XR 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
$5,737.00Insurance Discount
-$5,497.31Price Negotiated by Insurer
$239.69Deductible 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 PRESSD NONPRESSD INHAL TRMENT BCE
$219.97CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56Creatine Kinase,Total SO
$6.51CT Brain Stroke Protocol w/o Contrast
$105.02Free T4 Level
$9.02Hemoglobin A1C
$9.71Intravenous infusion, hydration; each additional hour (List separately in addition to code for prima
$47.04MRA Brain/Head w/o Contrast
$239.69MRI Brain Stroke Protocol w/o Contrast
$239.69NT-proBNP SO
$39.26Thyroid Stimulating Hormone
$16.80Troponin-I
$12.47Urinalysis without Microscopic
$2.25US Carotid Duplex Bilateral
$239.69XR 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.