Patient Estimates

Disclaimer

This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created. The final bill and services may differ from what is listed. The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. There may be additional services that our facility recommends as part of the course of care for your condition. These services are not included in this estimate and will need to be requested separately and will receive their own estimate when scheduled. This estimate is not a contract. You may seek these services elsewhere from other facilities or providers not listed in this estimate. As a patient you have the right to initiate the patient-provider dispute resolution process if the bill is substantially in excess of the expected charges of this estimate. For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises (See link for Payment disagreements under the Consumer protections section) or call 1-877-696-6775. Opening a dispute will not adversely affect the quality of health care services furnished by our providers or facility.

Accept and continue