Estimated Out-of-Pocket Expenses

When determining the best option for a medical procedure, there are many things to consider. Just comparing the cost published on various websites may not provide the complete picture you need to make the most informed decision. That is why we recommend you reach out to our pricing analyst to help answer any questions you may have.

Call us at (502) 272-5330 for a cost estimate or use the form below. The estimate will be based on your insurance coverage or financial situation.

If you have the five-digit current procedural terminology (CPT) code that pertains to the services you will receive, please have it ready. Otherwise provide as much detail describing the services as you can.

It could take as little as five minutes to get a cost estimate.

Remember the prices are an estimate and not a guarantee of your final cost responsibility. If you call and leave a message, please allow up to two business days for a return call.

Hospital billing estimate

Name*
First Last
Phone*
Alternate phone number
Insurance Co.
Insurance deductible: Amount you have to pay out-of-pocket for expenses before your insurance will cover the remaining cost.
Co-Insurance: Amount you are responsible for after Deductible has been met. (Example: 90/10 or 80/20)
Procedure CPT code: CPT code is a 5-digit code that lets us know what you are having done. CPT code can only be given by your ordering physician.
Comments or questions
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