CPT 70460
The standard charge for CT scan of head with contrast is $6,082.00. However, the price you pay depends on the rate negotiated by your insurance plan and what portion your insurance plan requires you to contribute towards that amount. Enter your info below to start your estimate.
To calculate an estimate of your cost, you will need two things:
LOCATION
9440 Poppy Drive, Dallas, TX, 75218CONTACT
(214) 324-6100 Visit WebsiteChoose a plan to view the insurance rate estimate.
Total estimated charges
$6,082.00Insurance Discount
-$5,932.60Price Negotiated by Insurer
$149.40Deductible 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.
Bill Only BB Antibody Screen RBC
$10.26Blood Gas RT O2 Sat Meas BCE
$82.70CBC w/ Diff
$8.16CHED 99285 - Level 5 BCE
$2,500.00CHED Arterial Line Activity Blood Drawn BCE
$56.10CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$1,982.75Comprehensive Metabolic Panel
$11.10CT Angio Abdomen and Pelvis BCE
$439.48Lactic Acid Level
$12.14Lipase Level
$7.23Manual Differential
$3.99Neonate ABO/Rh
$3.13Rh Typing
$3.13RT CHARGE SpO2 Single BCE
$67.10RT EKG 12 Lead Tracing BCE
$10.11SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$84.15SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$165.00SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$181.50Urinalysis Microscopic
$3.32WC Glucose Blood Test BCE
$3.45XR Chest Abdomen Infant
$19.46This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,829.96Price Negotiated by Insurer
$252.04Deductible 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.
Bill Only BB Antibody Screen RBC
$74.34Blood Gas RT O2 Sat Meas BCE
$118.16CBC w/ Diff
$11.66CHED 99285 - Level 5 BCE
$881.13CHED Arterial Line Activity Blood Drawn BCE
$175.23CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$1,217.31Comprehensive Metabolic Panel
$15.84CT Angio Abdomen and Pelvis BCE
$527.56Lactic Acid Level
$17.36Lipase Level
$10.34Manual Differential
$5.70Neonate ABO/Rh
$175.23Rh Typing
$55.02RT EKG 12 Lead Tracing BCE
$83.91SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$65.16SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$294.03SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$65.16Urinalysis Microscopic
$4.76WC Glucose Blood Test BCE
$4.92XR Chest Abdomen Infant
$124.65This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,928.64Price Negotiated by Insurer
$153.36Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
Bill Only BB Antibody Screen RBC
$3.81Blood Gas RT O2 Sat Meas BCE
$30.72CBC w/ Diff
$3.03CHED 99285 - Level 5 BCE
$280.00CHED Arterial Line Activity Blood Drawn BCE
$9.18CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$324.45Comprehensive Metabolic Panel
$4.12CT Angio Abdomen and Pelvis BCE
$368.43dexamethasone 10 mg/mL PF Inj Soln 1 mL
$11.54Lactated Ringers IV Soln 1000 mL
$11.54Lactic Acid Level
$4.51Lipase Level
$2.69LOCM 300-399MG/ML IODINE PER ML
$0.60Manual Differential
$1.48Neonate ABO/Rh
$1.17ondansetron 4 mg Tab
$0.69pantoprazole 40 mg iv
$11.54Rh Typing
$1.17RT CHARGE SpO2 Single BCE
$10.98RT EKG 12 Lead Tracing BCE
$63.00SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$13.77SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$27.00SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$29.70Sodium Chloride 0.9% IV Soln 500 mL
$11.54Urinalysis Microscopic
$1.24WC Glucose Blood Test BCE
$1.28XR Chest Abdomen Infant
$26.06This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,913.97Price Negotiated by Insurer
$168.03Deductible 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.
Bill Only BB Antibody Screen RBC
$49.56Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77CHED 99285 - Level 5 BCE
$587.42CHED Arterial Line Activity Blood Drawn BCE
$116.82CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$811.54Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$351.71Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$116.82Rh Typing
$36.68RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44Urinalysis Microscopic
$3.17WC Glucose Blood Test BCE
$3.28XR Chest Abdomen Infant
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,913.97Price Negotiated by Insurer
$168.03Deductible 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.
Bill Only BB Antibody Screen RBC
$49.56Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77CHED 99285 - Level 5 BCE
$587.42CHED Arterial Line Activity Blood Drawn BCE
$116.82CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$811.54Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$351.71Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$116.82Rh Typing
$36.68RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44Urinalysis Microscopic
$3.17WC Glucose Blood Test BCE
$3.28XR Chest Abdomen Infant
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,781.34Price Negotiated by Insurer
$300.66Deductible 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.
Bill Only BB Antibody Screen RBC
$81.63Blood Gas RT O2 Sat Meas BCE
$129.97CBC w/ Diff
$12.82CHED 99285 - Level 5 BCE
$877.85CHED Arterial Line Activity Blood Drawn BCE
$182.08CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$1,159.99Comprehensive Metabolic Panel
$17.42CT Angio Abdomen and Pelvis BCE
$479.29dexamethasone 10 mg/mL PF Inj Soln 1 mL
$0.03Lactated Ringers IV Soln 1000 mL
$8.61Lactic Acid Level
$19.09Lipase Level
$11.37LOCM 300-399MG/ML IODINE PER ML
$0.46Manual Differential
$6.27Neonate ABO/Rh
$179.90ondansetron 4 mg Tab
$0.33pantoprazole 40 mg iv
$38.45Rh Typing
$55.16RT CHARGE SpO2 Single BCE
$4.38RT EKG 12 Lead Tracing BCE
$95.72SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$38.25SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$126.67SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$29.48Sodium Chloride 0.9% IV Soln 500 mL
$10.80Urinalysis Microscopic
$5.23WC Glucose Blood Test BCE
$5.41XR Chest Abdomen Infant
$131.69This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,721.20Price Negotiated by Insurer
$360.80Deductible 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.
Bill Only BB Antibody Screen RBC
$97.95Blood Gas RT O2 Sat Meas BCE
$155.96CBC w/ Diff
$15.38CHED 99285 - Level 5 BCE
$1,049.38CHED Arterial Line Activity Blood Drawn BCE
$218.06CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$1,386.65Comprehensive Metabolic Panel
$20.91CT Angio Abdomen and Pelvis BCE
$575.15dexamethasone 10 mg/mL PF Inj Soln 1 mL
$0.03Lactated Ringers IV Soln 1000 mL
$10.34Lactic Acid Level
$22.91Lipase Level
$13.64LOCM 300-399MG/ML IODINE PER ML
$0.56Manual Differential
$7.52Neonate ABO/Rh
$215.88ondansetron 4 mg Tab
$0.40pantoprazole 40 mg iv
$46.14Rh Typing
$66.19RT CHARGE SpO2 Single BCE
$5.24RT EKG 12 Lead Tracing BCE
$114.42SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$45.72SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$151.42SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$35.24Sodium Chloride 0.9% IV Soln 500 mL
$12.96Urinalysis Microscopic
$6.28WC Glucose Blood Test BCE
$6.49XR Chest Abdomen Infant
$158.02This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,913.97Price Negotiated by Insurer
$168.03Deductible 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.
Bill Only BB Antibody Screen RBC
$49.56Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77CHED 99285 - Level 5 BCE
$587.42CHED Arterial Line Activity Blood Drawn BCE
$116.82CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$811.54Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$351.71Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$116.82Rh Typing
$36.68RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44Urinalysis Microscopic
$3.17WC Glucose Blood Test BCE
$3.28XR Chest Abdomen Infant
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,679.29Price Negotiated by Insurer
$402.71Deductible 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.
Bill Only BB Antibody Screen RBC
$109.33Blood Gas RT O2 Sat Meas BCE
$174.08CBC w/ Diff
$17.17CHED 99285 - Level 5 BCE
$1,170.46CHED Arterial Line Activity Blood Drawn BCE
$274.76CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$1,546.65Comprehensive Metabolic Panel
$23.34CT Angio Abdomen and Pelvis BCE
$641.96dexamethasone 10 mg/mL PF Inj Soln 1 mL
$0.04Lactated Ringers IV Soln 1000 mL
$11.46Lactic Acid Level
$25.57Lipase Level
$15.23LOCM 300-399MG/ML IODINE PER ML
$0.62Manual Differential
$8.40Neonate ABO/Rh
$240.96ondansetron 4 mg Tab
$0.44pantoprazole 40 mg iv
$51.27Rh Typing
$73.88RT CHARGE SpO2 Single BCE
$5.85RT EKG 12 Lead Tracing BCE
$127.62SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$50.99SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$168.90SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$39.30Sodium Chloride 0.9% IV Soln 500 mL
$14.38Urinalysis Microscopic
$7.01WC Glucose Blood Test BCE
$7.25XR Chest Abdomen Infant
$176.38This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$729.84Price Negotiated by Insurer
$5,352.16Deductible 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.
Bill Only BB Antibody Screen RBC
$222.64Blood Gas RT O2 Sat Meas BCE
$829.84CBC w/ Diff
$164.56CHED 99285 - Level 5 BCE
$2,675.20CHED Arterial Line Activity Blood Drawn BCE
$89.76CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$3,172.40Comprehensive Metabolic Panel
$581.68CT Angio Abdomen and Pelvis BCE
$11,354.64dexamethasone 10 mg/mL PF Inj Soln 1 mL
$87.16Lactated Ringers IV Soln 1000 mL
$87.16Lactic Acid Level
$237.60Lipase Level
$241.12LOCM 300-399MG/ML IODINE PER ML
$5.89Manual Differential
$71.28Neonate ABO/Rh
$133.76ondansetron 4 mg Tab
$5.20pantoprazole 40 mg iv
$87.16Rh Typing
$99.44RT CHARGE SpO2 Single BCE
$107.36RT EKG 12 Lead Tracing BCE
$616.00SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$134.64SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$264.00SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$290.40Sodium Chloride 0.9% IV Soln 500 mL
$87.16Urinalysis Microscopic
$165.44WC Glucose Blood Test BCE
$37.84XR Chest Abdomen Infant
$584.32This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,701.35Price Negotiated by Insurer
$380.65Deductible 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.
Bill Only BB Antibody Screen RBC
$112.25CHED 99285 - Level 5 BCE
$3,123.61CHED Arterial Line Activity Blood Drawn BCE
$264.63CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$4,315.36CT Angio Abdomen and Pelvis BCE
$796.73Neonate ABO/Rh
$264.63Rh Typing
$83.09RT EKG 12 Lead Tracing BCE
$126.71SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$98.40SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$444.05SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$98.40XR Chest Abdomen Infant
$188.25This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,928.64Price Negotiated by Insurer
$153.36Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$368.43Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$2.99Rh Typing
$2.99Urinalysis Microscopic
$3.17XR Chest Abdomen Infant
$20.85This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,913.97Price Negotiated by Insurer
$168.03Deductible 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.
Bill Only BB Antibody Screen RBC
$49.56Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77CHED 99285 - Level 5 BCE
$587.42CHED Arterial Line Activity Blood Drawn BCE
$116.82CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$811.54Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$351.71Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$116.82Rh Typing
$36.68RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44Urinalysis Microscopic
$3.17WC Glucose Blood Test BCE
$3.28XR Chest Abdomen Infant
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,913.97Price Negotiated by Insurer
$168.03Deductible 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.
Bill Only BB Antibody Screen RBC
$49.56Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77CHED 99285 - Level 5 BCE
$587.42CHED Arterial Line Activity Blood Drawn BCE
$116.82CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$811.54Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$351.71Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$116.82Rh Typing
$36.68RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44Urinalysis Microscopic
$3.17WC Glucose Blood Test BCE
$3.28XR Chest Abdomen Infant
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,913.97Price Negotiated by Insurer
$168.03Deductible 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.
Bill Only BB Antibody Screen RBC
$49.56Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77CHED 99285 - Level 5 BCE
$587.42CHED Arterial Line Activity Blood Drawn BCE
$116.82CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$811.54Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$351.71Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$116.82Rh Typing
$36.68RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44Urinalysis Microscopic
$3.17WC Glucose Blood Test BCE
$3.28XR Chest Abdomen Infant
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,928.64Price Negotiated by Insurer
$153.36Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$368.43Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$2.99Rh Typing
$2.99Urinalysis Microscopic
$3.17XR Chest Abdomen Infant
$20.85This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,913.97Price Negotiated by Insurer
$168.03Deductible 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.
Bill Only BB Antibody Screen RBC
$49.56Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77CHED 99285 - Level 5 BCE
$587.42CHED Arterial Line Activity Blood Drawn BCE
$116.82CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$811.54Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$351.71Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$116.82Rh Typing
$36.68RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44Urinalysis Microscopic
$3.17WC Glucose Blood Test BCE
$3.28XR Chest Abdomen Infant
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,913.97Price Negotiated by Insurer
$168.03Deductible 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.
Bill Only BB Antibody Screen RBC
$49.56Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77CHED 99285 - Level 5 BCE
$587.42CHED Arterial Line Activity Blood Drawn BCE
$116.82CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$811.54Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$351.71Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$116.82Rh Typing
$36.68RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44Urinalysis Microscopic
$3.17WC Glucose Blood Test BCE
$3.28XR Chest Abdomen Infant
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$2,128.70Price Negotiated by Insurer
$3,953.30Deductible 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.
Bill Only BB Antibody Screen RBC
$164.45Blood Gas RT O2 Sat Meas BCE
$612.95CBC w/ Diff
$121.55CHED 99285 - Level 5 BCE
$1,976.00CHED Arterial Line Activity Blood Drawn BCE
$66.30CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$2,343.25Comprehensive Metabolic Panel
$429.65CT Angio Abdomen and Pelvis BCE
$8,386.95dexamethasone 10 mg/mL PF Inj Soln 1 mL
$83.31Lactated Ringers IV Soln 1000 mL
$83.31Lactic Acid Level
$175.50Lipase Level
$178.10LOCM 300-399MG/ML IODINE PER ML
$4.35Manual Differential
$52.65Neonate ABO/Rh
$98.80ondansetron 4 mg Tab
$4.97pantoprazole 40 mg iv
$83.31Rh Typing
$73.45RT CHARGE SpO2 Single BCE
$79.30RT EKG 12 Lead Tracing BCE
$455.00SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$99.45SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$195.00SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$214.50Sodium Chloride 0.9% IV Soln 500 mL
$83.31Urinalysis Microscopic
$122.20WC Glucose Blood Test BCE
$27.95XR Chest Abdomen Infant
$431.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$2,128.70Price Negotiated by Insurer
$3,953.30Deductible 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.
Bill Only BB Antibody Screen RBC
$164.45Blood Gas RT O2 Sat Meas BCE
$612.95CBC w/ Diff
$121.55CHED 99285 - Level 5 BCE
$1,976.00CHED Arterial Line Activity Blood Drawn BCE
$66.30CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$2,343.25Comprehensive Metabolic Panel
$429.65CT Angio Abdomen and Pelvis BCE
$8,386.95dexamethasone 10 mg/mL PF Inj Soln 1 mL
$83.31Lactated Ringers IV Soln 1000 mL
$83.31Lactic Acid Level
$175.50Lipase Level
$178.10LOCM 300-399MG/ML IODINE PER ML
$4.35Manual Differential
$52.65Neonate ABO/Rh
$98.80ondansetron 4 mg Tab
$4.97pantoprazole 40 mg iv
$83.31Rh Typing
$73.45RT CHARGE SpO2 Single BCE
$79.30RT EKG 12 Lead Tracing BCE
$455.00SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$99.45SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$195.00SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$214.50Sodium Chloride 0.9% IV Soln 500 mL
$83.31Urinalysis Microscopic
$122.20WC Glucose Blood Test BCE
$27.95XR Chest Abdomen Infant
$431.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$2,128.70Price Negotiated by Insurer
$3,953.30Deductible 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.
Bill Only BB Antibody Screen RBC
$164.45Blood Gas RT O2 Sat Meas BCE
$612.95CBC w/ Diff
$121.55CHED 99285 - Level 5 BCE
$1,976.00CHED Arterial Line Activity Blood Drawn BCE
$66.30CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$2,343.25Comprehensive Metabolic Panel
$429.65CT Angio Abdomen and Pelvis BCE
$8,386.95dexamethasone 10 mg/mL PF Inj Soln 1 mL
$83.31Lactated Ringers IV Soln 1000 mL
$83.31Lactic Acid Level
$175.50Lipase Level
$178.10LOCM 300-399MG/ML IODINE PER ML
$4.35Manual Differential
$52.65Neonate ABO/Rh
$98.80ondansetron 4 mg Tab
$4.97pantoprazole 40 mg iv
$83.31Rh Typing
$73.45RT CHARGE SpO2 Single BCE
$79.30RT EKG 12 Lead Tracing BCE
$455.00SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$99.45SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$195.00SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$214.50Sodium Chloride 0.9% IV Soln 500 mL
$83.31Urinalysis Microscopic
$122.20WC Glucose Blood Test BCE
$27.95XR Chest Abdomen Infant
$431.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,928.64Price Negotiated by Insurer
$153.36Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$368.43Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$2.99Rh Typing
$2.99Urinalysis Microscopic
$3.17XR Chest Abdomen Infant
$20.85This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$6,078.99Price Negotiated by Insurer
$3.01Deductible 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.
Bill Only BB Antibody Screen RBC
$12.21Blood Gas RT O2 Sat Meas BCE
$98.46CBC w/ Diff
$9.71CHED 99285 - Level 5 BCE
$10.51CHED Arterial Line Activity Blood Drawn BCE
$2.09CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$14.51Comprehensive Metabolic Panel
$13.20CT Angio Abdomen and Pelvis BCE
$6.29dexamethasone 10 mg/mL PF Inj Soln 1 mL
$64.08Lactated Ringers IV Soln 1000 mL
$64.08Lactic Acid Level
$14.46Lipase Level
$8.61LOCM 300-399MG/ML IODINE PER ML
$3.34Manual Differential
$4.75Neonate ABO/Rh
$3.74ondansetron 4 mg Tab
$3.82pantoprazole 40 mg iv
$64.08Rh Typing
$3.74RT CHARGE SpO2 Single BCE
$61.00RT EKG 12 Lead Tracing BCE
$1.00SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$0.78SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$3.51SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$0.78Sodium Chloride 0.9% IV Soln 500 mL
$64.08Urinalysis Microscopic
$3.96WC Glucose Blood Test BCE
$4.10XR Chest Abdomen Infant
$1.49This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,913.97Price Negotiated by Insurer
$168.03Deductible 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.
Bill Only BB Antibody Screen RBC
$49.56Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77CHED 99285 - Level 5 BCE
$587.42CHED Arterial Line Activity Blood Drawn BCE
$116.82CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$811.54Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$351.71Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$116.82Rh Typing
$36.68RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44Urinalysis Microscopic
$3.17WC Glucose Blood Test BCE
$3.28XR Chest Abdomen Infant
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,928.64Price Negotiated by Insurer
$153.36Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$368.43Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$2.99Rh Typing
$2.99Urinalysis Microscopic
$3.17XR Chest Abdomen Infant
$20.85This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,913.97Price Negotiated by Insurer
$168.03Deductible 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.
Bill Only BB Antibody Screen RBC
$49.56Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77CHED 99285 - Level 5 BCE
$587.42CHED Arterial Line Activity Blood Drawn BCE
$116.82CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$811.54Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$351.71dexamethasone 10 mg/mL PF Inj Soln 1 mL
$17.43Lactated Ringers IV Soln 1000 mL
$17.43Lactic Acid Level
$11.57Lipase Level
$6.89LOCM 300-399MG/ML IODINE PER ML
$0.91Manual Differential
$3.80Neonate ABO/Rh
$116.82ondansetron 4 mg Tab
$1.04pantoprazole 40 mg iv
$17.43Rh Typing
$36.68RT CHARGE SpO2 Single BCE
$16.59RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44Sodium Chloride 0.9% IV Soln 500 mL
$17.43Urinalysis Microscopic
$3.17WC Glucose Blood Test BCE
$3.28XR Chest Abdomen Infant
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,913.97Price Negotiated by Insurer
$168.03Deductible 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.
Bill Only BB Antibody Screen RBC
$49.56Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77CHED 99285 - Level 5 BCE
$587.42CHED Arterial Line Activity Blood Drawn BCE
$116.82CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$811.54Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$351.71Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$116.82Rh Typing
$36.68RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44Urinalysis Microscopic
$3.17WC Glucose Blood Test BCE
$3.28XR Chest Abdomen Infant
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,913.97Price Negotiated by Insurer
$168.03Deductible 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.
Bill Only BB Antibody Screen RBC
$49.56Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77CHED 99285 - Level 5 BCE
$587.42CHED Arterial Line Activity Blood Drawn BCE
$116.82CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$811.54Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$351.71Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$116.82Rh Typing
$36.68RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44Urinalysis Microscopic
$3.17WC Glucose Blood Test BCE
$3.28XR Chest Abdomen Infant
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,913.97Price Negotiated by Insurer
$168.03Deductible 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.
Bill Only BB Antibody Screen RBC
$49.56Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77CHED 99285 - Level 5 BCE
$587.42CHED Arterial Line Activity Blood Drawn BCE
$116.82CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$811.54Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$351.71Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$116.82Rh Typing
$36.68RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44Urinalysis Microscopic
$3.17WC Glucose Blood Test BCE
$3.28XR Chest Abdomen Infant
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,913.97Price Negotiated by Insurer
$168.03Deductible 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.
Bill Only BB Antibody Screen RBC
$49.56Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77CHED 99285 - Level 5 BCE
$587.42CHED Arterial Line Activity Blood Drawn BCE
$116.82CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$811.54Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$351.71Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$116.82Rh Typing
$36.68RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44Urinalysis Microscopic
$3.17WC Glucose Blood Test BCE
$3.28XR Chest Abdomen Infant
$83.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$6,082.00Insurance Discount
-$5,913.97Price Negotiated by Insurer
$168.03Deductible 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.
Bill Only BB Antibody Screen RBC
$49.56Blood Gas RT O2 Sat Meas BCE
$78.77CBC w/ Diff
$7.77CHED 99285 - Level 5 BCE
$587.42CHED Arterial Line Activity Blood Drawn BCE
$116.82CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291
$811.54Comprehensive Metabolic Panel
$10.56CT Angio Abdomen and Pelvis BCE
$351.71Lactic Acid Level
$11.57Lipase Level
$6.89Manual Differential
$3.80Neonate ABO/Rh
$116.82Rh Typing
$36.68RT EKG 12 Lead Tracing BCE
$55.94SDS Inf Ther Proph Dx Each Addl Hr 96366 BCE
$43.44SDS Inf Tx Prophylaxis Dx up to 1 Hour 96365 BCE
$196.02SDS Tx Proph Diag Ea Addl IVP Drug 96375 BCE
$43.44Urinalysis Microscopic
$3.17WC Glucose Blood Test BCE
$3.28XR Chest Abdomen Infant
$83.10This 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.