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Presupuestos para el paciente


This Patient Estimate is only an estimate (or approximation) of what I may pay, and does not represent a guarantee of the total and final costs for all medical services provided and received. I understand this is an estimate based on the information pro vided by myself and/or my insurance carrier at the date and time of this inquiry. Final costs may increase or decrease based on my insurance contract and benefits, medical condition, and any additional testing, procedures, supplies, or medications ordere d by my provider. This Patient Estimate does not create a request for, a consent to, or an agreement with Ann & Robert H. Lurie Children's Hospital of Chicago and its Corporate Affiliates for the provision of medical services or procedures. I can contact Registration at (312) 227-1333 if I have any question about the Estimate, if I am uninsured, or if I want information about the Financial Assistance Program. For the full terms and conditions of use of MyChart, please refer to the Terms and Conditions l ink available at the bottom of this page. By clicking "Accept and Continue" below, I agree to the terms of this Patient Estimate, as described above. The following services are not offered at Lurie Children's Hospital: Mammography (CPT 77065-77067), Preventative Visit-Age 40+ (CPT 99386), Birth/Delivery (CPT 59400/59510/59610), OB Blood Panel (CPT 80061), Adult Heart Procedures (CPT 93000/93452), and Joint Replacement (DRG 470). Surgical estimates are based on available data and the "You Pay" ma y have a high degree of error when a service is performed rarely. These services include: Cardiac Value (DRG 216), Spinal Fusion (DRG 460), Cervical Spinal Fusion (DRG 473), Uterine Procedure (DRG 743). Please call (312) 227-1333 for additional informat ion.

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