CPT 99292
The standard charge for Emergency Critical Care, Each Additional 30 Minutes is $1,680.00. 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
$1,680.00Insurance Discount
-$1,528.80Price Negotiated by Insurer
$151.20Deductible 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
$3.03Blood Culture
$4.02CHED 96365- IV tx, first hour BCE
$27.00CHED Airway/Intubation Procedures Endotracheal Intubation BCE
$103.99CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291 BCE
$324.45CHED INSJ TEMP NDWELLG BLD CATH SMPL BCE
$50.76CHED LineProcedure Central Line >= 5 y/o BCE
$279.53CHED Routine ECG 12 lead/15 lead tracing only BCE
$60.57COLLECTION: Venous Draw
$1.17Comprehensive Metabolic Panel
$4.12CT Brain Stroke Protocol w/o Contrast
$104.75DOPamine 40 mg/mL IV Soln 10 mL
$11.52Drug Screen 10 w/Conf,
$24.23empagliflozin 10mg tab
$6.46Eosinophil Urine
$1.67Lactic Acid Level
$4.51Manual Differential
$1.48Sodium Chloride 0.9% IV Soln 50 mL
$11.54Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$29.70Troponin-I
$4.86Urinalysis Microscopic
$1.24vancomycin 500 mg IV Inj
$11.54XR Chest
$25.73This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$1,680.00Price Negotiated by Insurer
$2,640.00Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$116.10Blood Culture
$117.30CHED 96365- IV tx, first hour BCE
$90.00CHED Airway/Intubation Procedures Endotracheal Intubation BCE
$340.08CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291 BCE
$2,640.00CHED INSJ TEMP NDWELLG BLD CATH SMPL BCE
$182.08CHED LineProcedure Central Line >= 5 y/o BCE
$2,723.99CHED Routine ECG 12 lead/15 lead tracing only BCE
$201.90COLLECTION: Venous Draw
$14.10Comprehensive Metabolic Panel
$198.30CT Brain Stroke Protocol w/o Contrast
$184.93DOPamine 40 mg/mL IV Soln 10 mL
$0.36Drug Screen 10 w/Conf,
$95.10empagliflozin 10mg tab
$21.55Eosinophil Urine
$41.40Lactic Acid Level
$81.00Manual Differential
$24.30Sodium Chloride 0.9% IV Soln 50 mL
$10.80Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$99.00Troponin-I
$132.60Urinalysis Microscopic
$56.40vancomycin 500 mg IV Inj
$2.06XR Chest
$131.69This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$1,680.00Price Negotiated by Insurer
$3,168.00Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$139.32Blood Culture
$140.76CHED 96365- IV tx, first hour BCE
$108.00CHED Airway/Intubation Procedures Endotracheal Intubation BCE
$407.28CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291 BCE
$3,168.00CHED INSJ TEMP NDWELLG BLD CATH SMPL BCE
$218.06CHED LineProcedure Central Line >= 5 y/o BCE
$3,262.26CHED Routine ECG 12 lead/15 lead tracing only BCE
$242.28COLLECTION: Venous Draw
$16.92Comprehensive Metabolic Panel
$237.96CT Brain Stroke Protocol w/o Contrast
$221.92DOPamine 40 mg/mL IV Soln 10 mL
$0.44Drug Screen 10 w/Conf,
$114.12empagliflozin 10mg tab
$25.86Eosinophil Urine
$49.68Lactic Acid Level
$97.20Manual Differential
$29.16Sodium Chloride 0.9% IV Soln 50 mL
$12.96Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$118.80Troponin-I
$159.12Urinalysis Microscopic
$67.68vancomycin 500 mg IV Inj
$2.47XR Chest
$158.02This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$1,680.00Price Negotiated by Insurer
$3,520.00Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$154.80Blood Culture
$156.40CHED 96365- IV tx, first hour BCE
$120.00CHED Airway/Intubation Procedures Endotracheal Intubation BCE
$513.17CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291 BCE
$3,520.00CHED INSJ TEMP NDWELLG BLD CATH SMPL BCE
$274.76CHED LineProcedure Central Line >= 5 y/o BCE
$4,110.45CHED Routine ECG 12 lead/15 lead tracing only BCE
$269.20COLLECTION: Venous Draw
$18.80Comprehensive Metabolic Panel
$264.40CT Brain Stroke Protocol w/o Contrast
$247.70DOPamine 40 mg/mL IV Soln 10 mL
$0.48Drug Screen 10 w/Conf,
$126.80empagliflozin 10mg tab
$28.73Eosinophil Urine
$55.20Lactic Acid Level
$108.00Manual Differential
$32.40Sodium Chloride 0.9% IV Soln 50 mL
$14.38Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$132.00Troponin-I
$176.80Urinalysis Microscopic
$75.20vancomycin 500 mg IV Inj
$2.74XR Chest
$176.38This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$1,680.00Insurance Discount
-$537.60Price Negotiated by Insurer
$1,142.40Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$263.16Blood Culture
$265.88CHED 96365- IV tx, first hour BCE
$204.00CHED Airway/Intubation Procedures Endotracheal Intubation BCE
$785.67CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291 BCE
$2,451.40CHED INSJ TEMP NDWELLG BLD CATH SMPL BCE
$383.52CHED LineProcedure Central Line >= 5 y/o BCE
$2,111.97CHED Routine ECG 12 lead/15 lead tracing only BCE
$457.64COLLECTION: Venous Draw
$31.96Comprehensive Metabolic Panel
$449.48CT Brain Stroke Protocol w/o Contrast
$3,056.60DOPamine 40 mg/mL IV Soln 10 mL
$87.04Drug Screen 10 w/Conf,
$215.56empagliflozin 10mg tab
$48.84Eosinophil Urine
$93.84Lactic Acid Level
$183.60Manual Differential
$55.08Sodium Chloride 0.9% IV Soln 50 mL
$87.16Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$224.40Troponin-I
$300.56Urinalysis Microscopic
$127.84vancomycin 500 mg IV Inj
$87.16XR Chest
$451.52This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$1,680.00Insurance Discount
-$470.40Price Negotiated by Insurer
$1,209.60Deductible 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
$278.64Blood Culture
$281.52CHED 96365- IV tx, first hour BCE
$216.00CHED Airway/Intubation Procedures Endotracheal Intubation BCE
$831.88CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291 BCE
$2,595.60CHED INSJ TEMP NDWELLG BLD CATH SMPL BCE
$406.08CHED LineProcedure Central Line >= 5 y/o BCE
$2,236.20CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56COLLECTION: Venous Draw
$33.84Comprehensive Metabolic Panel
$475.92CT Brain Stroke Protocol w/o Contrast
$3,236.40DOPamine 40 mg/mL IV Soln 10 mL
$92.16Drug Screen 10 w/Conf,
$228.24empagliflozin 10mg tab
$51.71Eosinophil Urine
$99.36Lactic Acid Level
$194.40Manual Differential
$58.32Sodium Chloride 0.9% IV Soln 50 mL
$92.28Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$237.60Troponin-I
$318.24Urinalysis Microscopic
$135.36vancomycin 500 mg IV Inj
$92.28XR Chest
$478.08This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$1,680.00Insurance Discount
-$470.40Price Negotiated by Insurer
$1,209.60Deductible 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
$278.64Blood Culture
$281.52CHED 96365- IV tx, first hour BCE
$216.00CHED Airway/Intubation Procedures Endotracheal Intubation BCE
$831.88CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291 BCE
$2,595.60CHED INSJ TEMP NDWELLG BLD CATH SMPL BCE
$406.08CHED LineProcedure Central Line >= 5 y/o BCE
$2,236.20CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56COLLECTION: Venous Draw
$33.84Comprehensive Metabolic Panel
$475.92CT Brain Stroke Protocol w/o Contrast
$3,236.40DOPamine 40 mg/mL IV Soln 10 mL
$92.16Drug Screen 10 w/Conf,
$228.24empagliflozin 10mg tab
$51.71Eosinophil Urine
$99.36Lactic Acid Level
$194.40Manual Differential
$58.32Sodium Chloride 0.9% IV Soln 50 mL
$92.28Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$237.60Troponin-I
$318.24Urinalysis Microscopic
$135.36vancomycin 500 mg IV Inj
$92.28XR Chest
$478.08This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$1,680.00Insurance Discount
-$588.00Price Negotiated by Insurer
$1,092.00Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$251.55Blood Culture
$254.15CHED 96365- IV tx, first hour BCE
$195.00CHED Airway/Intubation Procedures Endotracheal Intubation BCE
$751.00CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291 BCE
$2,343.25CHED INSJ TEMP NDWELLG BLD CATH SMPL BCE
$366.60CHED LineProcedure Central Line >= 5 y/o BCE
$2,018.80CHED Routine ECG 12 lead/15 lead tracing only BCE
$437.45COLLECTION: Venous Draw
$30.55Comprehensive Metabolic Panel
$429.65CT Brain Stroke Protocol w/o Contrast
$2,921.75DOPamine 40 mg/mL IV Soln 10 mL
$83.20Drug Screen 10 w/Conf,
$206.05empagliflozin 10mg tab
$46.68Eosinophil Urine
$89.70Lactic Acid Level
$175.50Manual Differential
$52.65Sodium Chloride 0.9% IV Soln 50 mL
$83.31Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$214.50Troponin-I
$287.30Urinalysis Microscopic
$122.20vancomycin 500 mg IV Inj
$83.31XR Chest
$431.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$1,680.00Insurance Discount
-$588.00Price Negotiated by Insurer
$1,092.00Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$251.55Blood Culture
$254.15CHED 96365- IV tx, first hour BCE
$195.00CHED Airway/Intubation Procedures Endotracheal Intubation BCE
$751.00CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291 BCE
$2,343.25CHED INSJ TEMP NDWELLG BLD CATH SMPL BCE
$366.60CHED LineProcedure Central Line >= 5 y/o BCE
$2,018.80CHED Routine ECG 12 lead/15 lead tracing only BCE
$437.45COLLECTION: Venous Draw
$30.55Comprehensive Metabolic Panel
$429.65CT Brain Stroke Protocol w/o Contrast
$2,921.75DOPamine 40 mg/mL IV Soln 10 mL
$83.20Drug Screen 10 w/Conf,
$206.05empagliflozin 10mg tab
$46.68Eosinophil Urine
$89.70Lactic Acid Level
$175.50Manual Differential
$52.65Sodium Chloride 0.9% IV Soln 50 mL
$83.31Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$214.50Troponin-I
$287.30Urinalysis Microscopic
$122.20vancomycin 500 mg IV Inj
$83.31XR Chest
$431.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$1,680.00Insurance Discount
-$588.00Price Negotiated by Insurer
$1,092.00Deductible 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.
85025 CBC W/AUTOMATED DIFFERENTIAL
$251.55Blood Culture
$254.15CHED 96365- IV tx, first hour BCE
$195.00CHED Airway/Intubation Procedures Endotracheal Intubation BCE
$751.00CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291 BCE
$2,343.25CHED INSJ TEMP NDWELLG BLD CATH SMPL BCE
$366.60CHED LineProcedure Central Line >= 5 y/o BCE
$2,018.80CHED Routine ECG 12 lead/15 lead tracing only BCE
$437.45COLLECTION: Venous Draw
$30.55Comprehensive Metabolic Panel
$429.65CT Brain Stroke Protocol w/o Contrast
$2,921.75DOPamine 40 mg/mL IV Soln 10 mL
$83.20Drug Screen 10 w/Conf,
$206.05empagliflozin 10mg tab
$46.68Eosinophil Urine
$89.70Lactic Acid Level
$175.50Manual Differential
$52.65Sodium Chloride 0.9% IV Soln 50 mL
$83.31Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$214.50Troponin-I
$287.30Urinalysis Microscopic
$122.20vancomycin 500 mg IV Inj
$83.31XR Chest
$431.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$1,680.00Insurance Discount
-$470.40Price Negotiated by Insurer
$1,209.60Deductible 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
$278.64Blood Culture
$281.52CHED 96365- IV tx, first hour BCE
$216.00CHED Airway/Intubation Procedures Endotracheal Intubation BCE
$831.88CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291 BCE
$2,595.60CHED INSJ TEMP NDWELLG BLD CATH SMPL BCE
$406.08CHED LineProcedure Central Line >= 5 y/o BCE
$2,236.20CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56COLLECTION: Venous Draw
$33.84Comprehensive Metabolic Panel
$475.92CT Brain Stroke Protocol w/o Contrast
$3,236.40DOPamine 40 mg/mL IV Soln 10 mL
$92.16Drug Screen 10 w/Conf,
$228.24empagliflozin 10mg tab
$51.71Eosinophil Urine
$99.36Lactic Acid Level
$194.40Manual Differential
$58.32Sodium Chloride 0.9% IV Soln 50 mL
$92.28Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$237.60Troponin-I
$318.24Urinalysis Microscopic
$135.36vancomycin 500 mg IV Inj
$92.28XR Chest
$478.08This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$1,680.00Insurance Discount
-$1,549.79Price Negotiated by Insurer
$130.21Deductible 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
$9.71Blood Culture
$12.90CHED 96365- IV tx, first hour BCE
$77.31CHED Airway/Intubation Procedures Endotracheal Intubation BCE
$170.07CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291 BCE
$258.57CHED INSJ TEMP NDWELLG BLD CATH SMPL BCE
$30.68CHED LineProcedure Central Line >= 5 y/o BCE
$101.69CHED Routine ECG 12 lead/15 lead tracing only BCE
$7.78COLLECTION: Venous Draw
$11.04Comprehensive Metabolic Panel
$13.20CT Brain Stroke Protocol w/o Contrast
$134.24DOPamine 40 mg/mL IV Soln 10 mL
$64.00Drug Screen 10 w/Conf,
$77.67empagliflozin 10mg tab
$35.91Eosinophil Urine
$5.34Lactic Acid Level
$14.46Manual Differential
$4.75Sodium Chloride 0.9% IV Soln 50 mL
$64.08Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$18.93Troponin-I
$15.59Urinalysis Microscopic
$3.96vancomycin 500 mg IV Inj
$64.08XR Chest
$31.66This 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
$1,680.00Insurance Discount
-$470.40Price Negotiated by Insurer
$1,209.60Deductible 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
$278.64Blood Culture
$281.52CHED 96365- IV tx, first hour BCE
$216.00CHED Airway/Intubation Procedures Endotracheal Intubation BCE
$831.88CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291 BCE
$2,595.60CHED INSJ TEMP NDWELLG BLD CATH SMPL BCE
$406.08CHED LineProcedure Central Line >= 5 y/o BCE
$2,236.20CHED Routine ECG 12 lead/15 lead tracing only BCE
$484.56COLLECTION: Venous Draw
$33.84Comprehensive Metabolic Panel
$475.92CT Brain Stroke Protocol w/o Contrast
$3,236.40DOPamine 40 mg/mL IV Soln 10 mL
$92.16Drug Screen 10 w/Conf,
$228.24empagliflozin 10mg tab
$51.71Eosinophil Urine
$99.36Lactic Acid Level
$194.40Manual Differential
$58.32Sodium Chloride 0.9% IV Soln 50 mL
$92.28Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$237.60Troponin-I
$318.24Urinalysis Microscopic
$135.36vancomycin 500 mg IV Inj
$92.28XR Chest
$478.08This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.
Total estimated charges
$1,680.00Insurance Discount
-$1,451.52Price Negotiated by Insurer
$228.48Deductible 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
$7.77Blood Culture
$10.32CHED 96365- IV tx, first hour BCE
$213.67CHED Airway/Intubation Procedures Endotracheal Intubation BCE
$237.93CHED Critical Care Ill/Injured Patient Init 30-74 Min 99291 BCE
$829.79CHED INSJ TEMP NDWELLG BLD CATH SMPL BCE
$133.65CHED LineProcedure Central Line >= 5 y/o BCE
$3,171.87CHED Routine ECG 12 lead/15 lead tracing only BCE
$59.26COLLECTION: Venous Draw
$9.34Comprehensive Metabolic Panel
$10.56CT Brain Stroke Protocol w/o Contrast
$105.02DOPamine 40 mg/mL IV Soln 10 mL
$17.41Drug Screen 10 w/Conf,
$62.14empagliflozin 10mg tab
$9.77Eosinophil Urine
$4.27Lactic Acid Level
$11.57Manual Differential
$3.80Sodium Chloride 0.9% IV Soln 50 mL
$17.43Therapy, Prophylactic, Diag Each Addl Seq IVP New Drug 96375
$47.04Troponin-I
$12.47Urinalysis Microscopic
$3.17vancomycin 500 mg IV Inj
$17.43XR Chest
$87.42This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to White Rock Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact White Rock Medical Center directly at (214) 324-6100.