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Cost Estimates


I acknowledge this is only an estimate of the out-of-pocket costs I may be financially responsible for and does not represent a guarantee. The actual out-of-pocket costs I am responsible for may be higher or lower than the estimate provided here. Estimates are based on historical data on similar services. I understand that actual costs may vary based on my specific health condition, level of benefits, unknown circumstances and treatment by my physician or surgeon. This estimate may vary from the estimate provided by Texas Health Resources once my service is scheduled and is based on my physician’s order and verified payor benefits. This estimate is for hospital charges only and does not include any provider, physicians or any other professional fees or charges.

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