CPT 72080
The standard charge for X-ray thoracic-lumbar spine, 2 views is $336.00. 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
$336.00Insurance Discount
-$307.67Price Negotiated by Insurer
$28.33Deductible 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 99284 - Level 4 BCE
$2,350.00RT EKG 12 Lead Tracing BCE
$10.11SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$154.00XR Chest Abdomen Infant
$19.46XR Hip 2-3 Views Right BCE
$41.42XR Pelvis 1 or 2 Views BCE
$22.16XR Shoulder Complete 2+ Views Right BCE
$29.10XR Spine Cervical 2 or 3 Views BCE
$32.95XR Spine Lumbosacral 2 or 3 Views BCE
$33.34This 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
$336.00Insurance Discount
-$211.35Price Negotiated by Insurer
$124.65Deductible 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 99284 - Level 4 BCE
$607.59RT EKG 12 Lead Tracing BCE
$83.91SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$96.64XR Chest Abdomen Infant
$124.65XR Hip 2-3 Views Right BCE
$124.65XR Pelvis 1 or 2 Views BCE
$150.82XR Shoulder Complete 2+ Views Right BCE
$124.65XR Spine Cervical 2 or 3 Views BCE
$124.65XR Spine Lumbosacral 2 or 3 Views BCE
$150.82This 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
$336.00Insurance Discount
-$301.25Price Negotiated by Insurer
$34.75Deductible 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 99284 - Level 4 BCE
$280.00ketorolac 30 mg/mL Inj Soln 1 mL
$11.54oxyCODONE 10 mg ER Tab
$0.72RT EKG 12 Lead Tracing BCE
$63.00SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$25.20XR Chest Abdomen Infant
$26.06XR Hip 2-3 Views Right BCE
$47.11XR Pelvis 1 or 2 Views BCE
$28.06XR Shoulder Complete 2+ Views Right BCE
$34.75XR Spine Cervical 2 or 3 Views BCE
$39.76XR Spine Lumbosacral 2 or 3 Views BCE
$40.10This 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
$336.00Insurance Discount
-$252.90Price Negotiated by Insurer
$83.10Deductible 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 99284 - Level 4 BCE
$405.06RT EKG 12 Lead Tracing BCE
$55.94SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Chest Abdomen Infant
$83.10XR Hip 2-3 Views Right BCE
$83.10XR Pelvis 1 or 2 Views BCE
$100.55XR Shoulder Complete 2+ Views Right BCE
$83.10XR Spine Cervical 2 or 3 Views BCE
$83.10XR Spine Lumbosacral 2 or 3 Views BCE
$100.55This 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
$336.00Insurance Discount
-$252.90Price Negotiated by Insurer
$83.10Deductible 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 99284 - Level 4 BCE
$405.06RT EKG 12 Lead Tracing BCE
$55.94SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Chest Abdomen Infant
$83.10XR Hip 2-3 Views Right BCE
$83.10XR Pelvis 1 or 2 Views BCE
$100.55XR Shoulder Complete 2+ Views Right BCE
$83.10XR Spine Cervical 2 or 3 Views BCE
$83.10XR Spine Lumbosacral 2 or 3 Views BCE
$100.55This 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
$336.00Insurance Discount
-$204.31Price Negotiated by Insurer
$131.69Deductible 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.
CHED 99284 - Level 4 BCE
$612.11ketorolac 30 mg/mL Inj Soln 1 mL
$0.26oxyCODONE 10 mg ER Tab
$2.40RT EKG 12 Lead Tracing BCE
$95.72SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$105.22XR Chest Abdomen Infant
$131.69XR Hip 2-3 Views Right BCE
$131.69XR Pelvis 1 or 2 Views BCE
$184.93XR Shoulder Complete 2+ Views Right BCE
$131.69XR Spine Cervical 2 or 3 Views BCE
$131.69XR Spine Lumbosacral 2 or 3 Views BCE
$184.93This 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
$336.00Insurance Discount
-$177.98Price Negotiated by Insurer
$158.02Deductible 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.
CHED 99284 - Level 4 BCE
$731.72ketorolac 30 mg/mL Inj Soln 1 mL
$0.31oxyCODONE 10 mg ER Tab
$2.88RT EKG 12 Lead Tracing BCE
$114.42SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$125.78XR Chest Abdomen Infant
$158.02XR Hip 2-3 Views Right BCE
$158.02XR Pelvis 1 or 2 Views BCE
$221.92XR Shoulder Complete 2+ Views Right BCE
$158.02XR Spine Cervical 2 or 3 Views BCE
$158.02XR Spine Lumbosacral 2 or 3 Views BCE
$221.92This 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
$336.00Insurance Discount
-$252.90Price Negotiated by Insurer
$83.10Deductible 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 99284 - Level 4 BCE
$405.06RT EKG 12 Lead Tracing BCE
$55.94SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Chest Abdomen Infant
$83.10XR Hip 2-3 Views Right BCE
$83.10XR Pelvis 1 or 2 Views BCE
$100.55XR Shoulder Complete 2+ Views Right BCE
$83.10XR Spine Cervical 2 or 3 Views BCE
$83.10XR Spine Lumbosacral 2 or 3 Views BCE
$100.55This 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
$336.00Insurance Discount
-$159.62Price Negotiated by Insurer
$176.38Deductible 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 99284 - Level 4 BCE
$816.15ketorolac 30 mg/mL Inj Soln 1 mL
$0.35oxyCODONE 10 mg ER Tab
$3.20RT EKG 12 Lead Tracing BCE
$127.62SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$140.29XR Chest Abdomen Infant
$176.38XR Hip 2-3 Views Right BCE
$176.38XR Pelvis 1 or 2 Views BCE
$247.70XR Shoulder Complete 2+ Views Right BCE
$176.38XR Spine Cervical 2 or 3 Views BCE
$176.38XR Spine Lumbosacral 2 or 3 Views BCE
$247.70This 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
$336.00Insurance Discount
-$40.32Price Negotiated by Insurer
$295.68Deductible 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 99284 - Level 4 BCE
$1,862.96ketorolac 30 mg/mL Inj Soln 1 mL
$87.16oxyCODONE 10 mg ER Tab
$5.44RT EKG 12 Lead Tracing BCE
$616.00SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$246.40XR Chest Abdomen Infant
$584.32XR Hip 2-3 Views Right BCE
$543.84XR Pelvis 1 or 2 Views BCE
$480.48XR Shoulder Complete 2+ Views Right BCE
$549.12XR Spine Cervical 2 or 3 Views BCE
$501.60XR Spine Lumbosacral 2 or 3 Views BCE
$783.20This 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
$336.00Insurance Discount
-$147.75Price Negotiated by Insurer
$188.25Deductible 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.
CHED 99284 - Level 4 BCE
$1,613.02RT EKG 12 Lead Tracing BCE
$126.71SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$145.94XR Chest Abdomen Infant
$188.25XR Hip 2-3 Views Right BCE
$188.25XR Pelvis 1 or 2 Views BCE
$227.77XR Shoulder Complete 2+ Views Right BCE
$188.25XR Spine Cervical 2 or 3 Views BCE
$188.25XR Spine Lumbosacral 2 or 3 Views BCE
$227.77This 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
$336.00Insurance Discount
-$301.25Price Negotiated by Insurer
$34.75Deductible 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.
SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$11.23XR Chest Abdomen Infant
$20.85XR Hip 2-3 Views Right BCE
$47.11XR Pelvis 1 or 2 Views BCE
$28.06XR Shoulder Complete 2+ Views Right BCE
$34.75XR Spine Cervical 2 or 3 Views BCE
$39.76XR Spine Lumbosacral 2 or 3 Views BCE
$40.10This 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
$336.00Insurance Discount
-$252.90Price Negotiated by Insurer
$83.10Deductible 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 99284 - Level 4 BCE
$405.06RT EKG 12 Lead Tracing BCE
$55.94SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Chest Abdomen Infant
$83.10XR Hip 2-3 Views Right BCE
$83.10XR Pelvis 1 or 2 Views BCE
$100.55XR Shoulder Complete 2+ Views Right BCE
$83.10XR Spine Cervical 2 or 3 Views BCE
$83.10XR Spine Lumbosacral 2 or 3 Views BCE
$100.55This 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
$336.00Insurance Discount
-$252.90Price Negotiated by Insurer
$83.10Deductible 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 99284 - Level 4 BCE
$405.06RT EKG 12 Lead Tracing BCE
$55.94SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Chest Abdomen Infant
$83.10XR Hip 2-3 Views Right BCE
$83.10XR Pelvis 1 or 2 Views BCE
$100.55XR Shoulder Complete 2+ Views Right BCE
$83.10XR Spine Cervical 2 or 3 Views BCE
$83.10XR Spine Lumbosacral 2 or 3 Views BCE
$100.55This 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
$336.00Insurance Discount
-$252.90Price Negotiated by Insurer
$83.10Deductible 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 99284 - Level 4 BCE
$405.06RT EKG 12 Lead Tracing BCE
$55.94SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Chest Abdomen Infant
$83.10XR Hip 2-3 Views Right BCE
$83.10XR Pelvis 1 or 2 Views BCE
$100.55XR Shoulder Complete 2+ Views Right BCE
$83.10XR Spine Cervical 2 or 3 Views BCE
$83.10XR Spine Lumbosacral 2 or 3 Views BCE
$100.55This 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
$336.00Insurance Discount
-$301.25Price Negotiated by Insurer
$34.75Deductible 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.
SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$11.23XR Chest Abdomen Infant
$20.85XR Hip 2-3 Views Right BCE
$47.11XR Pelvis 1 or 2 Views BCE
$28.06XR Shoulder Complete 2+ Views Right BCE
$34.75XR Spine Cervical 2 or 3 Views BCE
$39.76XR Spine Lumbosacral 2 or 3 Views BCE
$40.10This 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
$336.00Insurance Discount
-$252.90Price Negotiated by Insurer
$83.10Deductible 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 99284 - Level 4 BCE
$405.06RT EKG 12 Lead Tracing BCE
$55.94SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Chest Abdomen Infant
$83.10XR Hip 2-3 Views Right BCE
$83.10XR Pelvis 1 or 2 Views BCE
$100.55XR Shoulder Complete 2+ Views Right BCE
$83.10XR Spine Cervical 2 or 3 Views BCE
$83.10XR Spine Lumbosacral 2 or 3 Views BCE
$100.55This 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
$336.00Insurance Discount
-$252.90Price Negotiated by Insurer
$83.10Deductible 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 99284 - Level 4 BCE
$405.06RT EKG 12 Lead Tracing BCE
$55.94SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Chest Abdomen Infant
$83.10XR Hip 2-3 Views Right BCE
$83.10XR Pelvis 1 or 2 Views BCE
$100.55XR Shoulder Complete 2+ Views Right BCE
$83.10XR Spine Cervical 2 or 3 Views BCE
$83.10XR Spine Lumbosacral 2 or 3 Views BCE
$100.55This 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
$336.00Insurance Discount
-$117.60Price Negotiated by Insurer
$218.40Deductible 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.
CHED 99284 - Level 4 BCE
$1,376.05ketorolac 30 mg/mL Inj Soln 1 mL
$83.31oxyCODONE 10 mg ER Tab
$5.20RT EKG 12 Lead Tracing BCE
$455.00SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$182.00XR Chest Abdomen Infant
$431.60XR Hip 2-3 Views Right BCE
$401.70XR Pelvis 1 or 2 Views BCE
$354.90XR Shoulder Complete 2+ Views Right BCE
$405.60XR Spine Cervical 2 or 3 Views BCE
$370.50XR Spine Lumbosacral 2 or 3 Views BCE
$578.50This 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
$336.00Insurance Discount
-$117.60Price Negotiated by Insurer
$218.40Deductible 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.
CHED 99284 - Level 4 BCE
$1,376.05ketorolac 30 mg/mL Inj Soln 1 mL
$83.31oxyCODONE 10 mg ER Tab
$5.20RT EKG 12 Lead Tracing BCE
$455.00SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$182.00XR Chest Abdomen Infant
$431.60XR Hip 2-3 Views Right BCE
$401.70XR Pelvis 1 or 2 Views BCE
$354.90XR Shoulder Complete 2+ Views Right BCE
$405.60XR Spine Cervical 2 or 3 Views BCE
$370.50XR Spine Lumbosacral 2 or 3 Views BCE
$578.50This 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
$336.00Insurance Discount
-$117.60Price Negotiated by Insurer
$218.40Deductible 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.
CHED 99284 - Level 4 BCE
$1,376.05ketorolac 30 mg/mL Inj Soln 1 mL
$83.31oxyCODONE 10 mg ER Tab
$5.20RT EKG 12 Lead Tracing BCE
$455.00SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$182.00XR Chest Abdomen Infant
$431.60XR Hip 2-3 Views Right BCE
$401.70XR Pelvis 1 or 2 Views BCE
$354.90XR Shoulder Complete 2+ Views Right BCE
$405.60XR Spine Cervical 2 or 3 Views BCE
$370.50XR Spine Lumbosacral 2 or 3 Views BCE
$578.50This 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
$336.00Insurance Discount
-$301.25Price Negotiated by Insurer
$34.75Deductible 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.
SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$11.23XR Chest Abdomen Infant
$20.85XR Hip 2-3 Views Right BCE
$47.11XR Pelvis 1 or 2 Views BCE
$28.06XR Shoulder Complete 2+ Views Right BCE
$34.75XR Spine Cervical 2 or 3 Views BCE
$39.76XR Spine Lumbosacral 2 or 3 Views BCE
$40.10This 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
$336.00Insurance Discount
-$334.51Price Negotiated by Insurer
$1.49Deductible 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 99284 - Level 4 BCE
$7.24ketorolac 30 mg/mL Inj Soln 1 mL
$64.08oxyCODONE 10 mg ER Tab
$4.00RT EKG 12 Lead Tracing BCE
$1.00SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$1.15XR Chest Abdomen Infant
$1.49XR Hip 2-3 Views Right BCE
$1.49XR Pelvis 1 or 2 Views BCE
$1.80XR Shoulder Complete 2+ Views Right BCE
$1.49XR Spine Cervical 2 or 3 Views BCE
$1.49XR Spine Lumbosacral 2 or 3 Views BCE
$1.80This 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
$336.00Insurance Discount
-$252.90Price Negotiated by Insurer
$83.10Deductible 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 99284 - Level 4 BCE
$405.06RT EKG 12 Lead Tracing BCE
$55.94SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Chest Abdomen Infant
$83.10XR Hip 2-3 Views Right BCE
$83.10XR Pelvis 1 or 2 Views BCE
$100.55XR Shoulder Complete 2+ Views Right BCE
$83.10XR Spine Cervical 2 or 3 Views BCE
$83.10XR Spine Lumbosacral 2 or 3 Views BCE
$100.55This 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
$336.00Insurance Discount
-$301.25Price Negotiated by Insurer
$34.75Deductible 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.
SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$11.23XR Chest Abdomen Infant
$20.85XR Hip 2-3 Views Right BCE
$47.11XR Pelvis 1 or 2 Views BCE
$28.06XR Shoulder Complete 2+ Views Right BCE
$34.75XR Spine Cervical 2 or 3 Views BCE
$39.76XR Spine Lumbosacral 2 or 3 Views BCE
$40.10This 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
$336.00Insurance Discount
-$252.90Price Negotiated by Insurer
$83.10Deductible 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 99284 - Level 4 BCE
$405.06ketorolac 30 mg/mL Inj Soln 1 mL
$17.43oxyCODONE 10 mg ER Tab
$1.09RT EKG 12 Lead Tracing BCE
$55.94SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Chest Abdomen Infant
$83.10XR Hip 2-3 Views Right BCE
$83.10XR Pelvis 1 or 2 Views BCE
$100.55XR Shoulder Complete 2+ Views Right BCE
$83.10XR Spine Cervical 2 or 3 Views BCE
$83.10XR Spine Lumbosacral 2 or 3 Views BCE
$100.55This 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
$336.00Insurance Discount
-$252.90Price Negotiated by Insurer
$83.10Deductible 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 99284 - Level 4 BCE
$405.06RT EKG 12 Lead Tracing BCE
$55.94SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Chest Abdomen Infant
$83.10XR Hip 2-3 Views Right BCE
$83.10XR Pelvis 1 or 2 Views BCE
$100.55XR Shoulder Complete 2+ Views Right BCE
$83.10XR Spine Cervical 2 or 3 Views BCE
$83.10XR Spine Lumbosacral 2 or 3 Views BCE
$100.55This 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
$336.00Insurance Discount
-$252.90Price Negotiated by Insurer
$83.10Deductible 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 99284 - Level 4 BCE
$405.06RT EKG 12 Lead Tracing BCE
$55.94SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Chest Abdomen Infant
$83.10XR Hip 2-3 Views Right BCE
$83.10XR Pelvis 1 or 2 Views BCE
$100.55XR Shoulder Complete 2+ Views Right BCE
$83.10XR Spine Cervical 2 or 3 Views BCE
$83.10XR Spine Lumbosacral 2 or 3 Views BCE
$100.55This 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
$336.00Insurance Discount
-$252.90Price Negotiated by Insurer
$83.10Deductible 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 99284 - Level 4 BCE
$405.06RT EKG 12 Lead Tracing BCE
$55.94SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Chest Abdomen Infant
$83.10XR Hip 2-3 Views Right BCE
$83.10XR Pelvis 1 or 2 Views BCE
$100.55XR Shoulder Complete 2+ Views Right BCE
$83.10XR Spine Cervical 2 or 3 Views BCE
$83.10XR Spine Lumbosacral 2 or 3 Views BCE
$100.55This 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
$336.00Insurance Discount
-$252.90Price Negotiated by Insurer
$83.10Deductible 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 99284 - Level 4 BCE
$405.06RT EKG 12 Lead Tracing BCE
$55.94SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Chest Abdomen Infant
$83.10XR Hip 2-3 Views Right BCE
$83.10XR Pelvis 1 or 2 Views BCE
$100.55XR Shoulder Complete 2+ Views Right BCE
$83.10XR Spine Cervical 2 or 3 Views BCE
$83.10XR Spine Lumbosacral 2 or 3 Views BCE
$100.55This 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
$336.00Insurance Discount
-$252.90Price Negotiated by Insurer
$83.10Deductible 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 99284 - Level 4 BCE
$405.06RT EKG 12 Lead Tracing BCE
$55.94SDS Tx Proph Diag Injection SQ or IM 96372 BCE
$64.43XR Chest Abdomen Infant
$83.10XR Hip 2-3 Views Right BCE
$83.10XR Pelvis 1 or 2 Views BCE
$100.55XR Shoulder Complete 2+ Views Right BCE
$83.10XR Spine Cervical 2 or 3 Views BCE
$83.10XR Spine Lumbosacral 2 or 3 Views BCE
$100.55This 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.