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Request a Patient Cost Estimate


To request an estimate of your out-of-pocket expenses for future services, please click the button below. For the most accurate estimate, please log-in to your MyChart account when you begin the estimate request process.

Please keep in mind that this is an estimate and actual out of pocket expenses may vary as a result of the quality and accuracy of the information provided when making the request, the actual care provided at the time of service, and the level of coverage applied by your insurance (if any) when they process your claim.

Request a Patient Cost Estimate

What happens when you submit an estimate request:

  • A Valley Health Estimates Coordinator will prepare an estimate using the information you submitted.
  • If you have insurance, Valley Health will verify your level of benefits with your insurance company, including the current status of any outstanding deductible or other Out-Of-Pocket (OOP) remaining for your current plan year
  • If we need additional information to prepare an accurate estimate, we will contact you using the communication preference you indicate.
  • Although estimates are usually provided in one business day, in some cases it may take slightly longer.

What will be provided in your estimate:

  • The estimated total charges.
  • If you have insurance, the allowed amount or negotiated rate between Valley Health and your insurance plan. This amount is usually less than the total charges. If you are uninsured or the estimate is for a service that is not covered by your insurance, there will not be a negotiated rate. Valley Health provides a 35% Uninsured Discount for patients without insurance coverage.
  • The amount “You Pay” before discounts. This amount is the estimated Patient Responsibility or Out-Of-Pocket (OOP) amount that we expect your insurance to apply to your share of the cost, or the discounted Uninsured rate for patients without insurance. If you have insurance, this amount is usually a combination of one or more of your benefit plan’s Co-Pay, Coinsurance, and any remaining Deductible, as defined by your employer or insurance group. This amount will not exceed the allowed amount or negotiated rate for covered services.
  • A “Prepayment Due” amount that reflects a Prepayment discount. This is the amount “You Pay” less a 10% discount if you choose to prepay. Although prepayment is not required for most services, to receive this reduced rate, you must prepay the Prepayment Due amount before receiving the service.

If you have questions please contact For more on price transparency, click here.