The estimated costs provided on the following pages does not include any physician charges (including pre-procedure office visits, surgeon, anesthesiologist, radiologist, pathologist, consulting physicians, etc.).

If you have insurance, your insurance policy coverage (including deductibles, co-pay, co-insurance, and out-of-pocket maximums) will help determine the amount you owe.

Note: The estimated cost is not a guarantee of insurance coverage. Please check with your insurance company if you need help understanding your benefits for the service chosen.
 

I HAVE READ THE DISCLAIMER AND UNDERSTAND THE INFORMATION ON THE FOLLOWING PAGES IS AN ESTIMATE ONLY. THE ACTUAL AMOUNT I WILL BE REQUIRED TO PAY MAY BE, AND LIKELY WILL BE, DIFFERENT.