CPT 72050
The standard charge for X-ray cervical spine, 4 or more views is $685.00. 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
$685.00Insurance Discount
-$631.20Price Negotiated by Insurer
$53.80Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$3.03CHED 96374- IV Injection, single/initial BCE
$32.40CHED 99283 - Level 3 BCE
$280.00CHED 99285 - Level 5 BCE
$280.00CHED Routine ECG 12 lead/15 lead tracing only BCE
$60.57Comprehensive Metabolic Panel
$4.12ketorolac 15 mg/mL Inj Soln 1 mL
$11.52This 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
$685.00Insurance Discount
-$579.98Price Negotiated by Insurer
$105.02Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99283 - Level 3 BCE
$274.22CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56ketorolac 15 mg/mL Inj Soln 1 mL
$0.33This 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
$685.00Insurance Discount
-$579.98Price Negotiated by Insurer
$105.02Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99283 - Level 3 BCE
$274.22CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56ketorolac 15 mg/mL Inj Soln 1 mL
$0.33This 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
$685.00Insurance Discount
-$500.07Price Negotiated by Insurer
$184.93Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$116.10CHED 96374- IV Injection, single/initial BCE
$108.00CHED 99283 - Level 3 BCE
$977.00CHED 99285 - Level 5 BCE
$2,640.00CHED Routine ECG 12 lead/15 lead tracing only BCE
$201.90Comprehensive Metabolic Panel
$198.30ketorolac 15 mg/mL Inj Soln 1 mL
$0.26This 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
$685.00Insurance Discount
-$463.08Price Negotiated by Insurer
$221.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$139.32CHED 96374- IV Injection, single/initial BCE
$129.60CHED 99283 - Level 3 BCE
$1,172.00CHED 99285 - Level 5 BCE
$3,168.00CHED Routine ECG 12 lead/15 lead tracing only BCE
$242.28Comprehensive Metabolic Panel
$237.96ketorolac 15 mg/mL Inj Soln 1 mL
$0.31This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$685.00Insurance Discount
-$579.98Price Negotiated by Insurer
$105.02Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99283 - Level 3 BCE
$274.22CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56ketorolac 15 mg/mL Inj Soln 1 mL
$0.33This 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
$685.00Insurance Discount
-$437.30Price Negotiated by Insurer
$247.70Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$154.80CHED 96374- IV Injection, single/initial BCE
$144.00CHED 99283 - Level 3 BCE
$1,302.00CHED 99285 - Level 5 BCE
$3,520.00CHED Routine ECG 12 lead/15 lead tracing only BCE
$269.20Comprehensive Metabolic Panel
$264.40ketorolac 15 mg/mL Inj Soln 1 mL
$0.35This 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
$685.00Insurance Discount
-$219.20Price Negotiated by Insurer
$465.80Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$263.16CHED 96374- IV Injection, single/initial BCE
$244.80CHED 99283 - Level 3 BCE
$1,056.72CHED 99285 - Level 5 BCE
$2,067.20CHED Routine ECG 12 lead/15 lead tracing only BCE
$457.64Comprehensive Metabolic Panel
$449.48ketorolac 15 mg/mL Inj Soln 1 mL
$87.04This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$685.00Insurance Discount
-$463.00Price Negotiated by Insurer
$222.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CHED 96374- IV Injection, single/initial BCE
$451.67CHED 99283 - Level 3 BCE
$1,018.97CHED 99285 - Level 5 BCE
$2,968.44CHED Routine ECG 12 lead/15 lead tracing only BCE
$125.27This 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
$685.00Insurance Discount
-$191.80Price Negotiated by Insurer
$493.20Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$278.64CHED 96374- IV Injection, single/initial BCE
$259.20CHED 99283 - Level 3 BCE
$1,118.88CHED 99285 - Level 5 BCE
$2,188.80CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56Comprehensive Metabolic Panel
$475.92ketorolac 15 mg/mL Inj Soln 1 mL
$92.16This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$685.00Insurance Discount
-$579.98Price Negotiated by Insurer
$105.02Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99283 - Level 3 BCE
$274.22CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56ketorolac 15 mg/mL Inj Soln 1 mL
$0.33This 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
$685.00Insurance Discount
-$579.98Price Negotiated by Insurer
$105.02Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99283 - Level 3 BCE
$274.22CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56ketorolac 15 mg/mL Inj Soln 1 mL
$0.33This 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
$685.00Insurance Discount
-$579.98Price Negotiated by Insurer
$105.02Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99283 - Level 3 BCE
$274.22CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56ketorolac 15 mg/mL Inj Soln 1 mL
$0.33This 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
$685.00Insurance Discount
-$191.80Price Negotiated by Insurer
$493.20Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$278.64CHED 96374- IV Injection, single/initial BCE
$259.20CHED 99283 - Level 3 BCE
$1,118.88CHED 99285 - Level 5 BCE
$2,188.80CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56Comprehensive Metabolic Panel
$475.92ketorolac 15 mg/mL Inj Soln 1 mL
$92.16This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$685.00Insurance Discount
-$579.98Price Negotiated by Insurer
$105.02Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99283 - Level 3 BCE
$274.22CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56ketorolac 15 mg/mL Inj Soln 1 mL
$0.33This 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
$685.00Insurance Discount
-$579.98Price Negotiated by Insurer
$105.02Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99283 - Level 3 BCE
$274.22CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56ketorolac 15 mg/mL Inj Soln 1 mL
$0.33This 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
$685.00Insurance Discount
-$239.75Price Negotiated by Insurer
$445.25Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$251.55CHED 96374- IV Injection, single/initial BCE
$234.00CHED 99283 - Level 3 BCE
$1,010.10CHED 99285 - Level 5 BCE
$1,976.00CHED Routine ECG 12 lead/15 lead tracing only BCE
$437.45Comprehensive Metabolic Panel
$429.65ketorolac 15 mg/mL Inj Soln 1 mL
$83.20This 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
$685.00Insurance Discount
-$239.75Price Negotiated by Insurer
$445.25Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$251.55CHED 96374- IV Injection, single/initial BCE
$234.00CHED 99283 - Level 3 BCE
$1,010.10CHED 99285 - Level 5 BCE
$1,976.00CHED Routine ECG 12 lead/15 lead tracing only BCE
$437.45Comprehensive Metabolic Panel
$429.65ketorolac 15 mg/mL Inj Soln 1 mL
$83.20This 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
$685.00Insurance Discount
-$239.75Price Negotiated by Insurer
$445.25Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$251.55CHED 96374- IV Injection, single/initial BCE
$234.00CHED 99283 - Level 3 BCE
$1,010.10CHED 99285 - Level 5 BCE
$1,976.00CHED Routine ECG 12 lead/15 lead tracing only BCE
$437.45Comprehensive Metabolic Panel
$429.65ketorolac 15 mg/mL Inj Soln 1 mL
$83.20This 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
$685.00Insurance Discount
-$191.80Price Negotiated by Insurer
$493.20Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$278.64CHED 96374- IV Injection, single/initial BCE
$259.20CHED 99283 - Level 3 BCE
$1,118.88CHED 99285 - Level 5 BCE
$2,188.80CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56Comprehensive Metabolic Panel
$475.92ketorolac 15 mg/mL Inj Soln 1 mL
$92.16This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$685.00Insurance Discount
-$618.70Price Negotiated by Insurer
$66.30Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$9.71CHED 96374- IV Injection, single/initial BCE
$45.26CHED 99283 - Level 3 BCE
$86.33CHED 99285 - Level 5 BCE
$212.75CHED Routine ECG 12 lead/15 lead tracing only BCE
$7.78Comprehensive Metabolic Panel
$13.20ketorolac 15 mg/mL Inj Soln 1 mL
$64.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$685.00Insurance Discount
-$579.98Price Negotiated by Insurer
$105.02Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99283 - Level 3 BCE
$274.22CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56ketorolac 15 mg/mL Inj Soln 1 mL
$0.33This 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
$685.00Insurance Discount
-$191.80Price Negotiated by Insurer
$493.20Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
85025 CBC W/AUTOMATED DIFFERENTIAL
$278.64CHED 96374- IV Injection, single/initial BCE
$259.20CHED 99283 - Level 3 BCE
$1,118.88CHED 99285 - Level 5 BCE
$2,188.80CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56Comprehensive Metabolic Panel
$475.92ketorolac 15 mg/mL Inj Soln 1 mL
$92.16This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$685.00Insurance Discount
-$579.98Price Negotiated by Insurer
$105.02Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99283 - Level 3 BCE
$274.22CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56ketorolac 15 mg/mL Inj Soln 1 mL
$0.33This 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
$685.00Insurance Discount
-$579.98Price Negotiated by Insurer
$105.02Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99283 - Level 3 BCE
$274.22CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56ketorolac 15 mg/mL Inj Soln 1 mL
$0.33This 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
$685.00Insurance Discount
-$579.98Price Negotiated by Insurer
$105.02Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99283 - Level 3 BCE
$274.22CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56ketorolac 15 mg/mL Inj Soln 1 mL
$0.33This 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
$685.00Insurance Discount
-$579.98Price Negotiated by Insurer
$105.02Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99283 - Level 3 BCE
$274.22CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56ketorolac 15 mg/mL Inj Soln 1 mL
$0.33This 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
$685.00Insurance Discount
-$579.98Price Negotiated by Insurer
$105.02Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99283 - Level 3 BCE
$274.22CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56ketorolac 15 mg/mL Inj Soln 1 mL
$0.33This 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
$685.00Insurance Discount
-$579.98Price Negotiated by Insurer
$105.02Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$7.77CHED 96374- IV Injection, single/initial BCE
$213.67CHED 99283 - Level 3 BCE
$274.22CHED 99285 - Level 5 BCE
$598.24CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26Comprehensive Metabolic Panel
$10.56ketorolac 15 mg/mL Inj Soln 1 mL
$0.33This 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.