Patient Cost Estimate Request

SoutheastHEALTH wants to help you understand the financial obligations and resources related to your medical care and services.

If you would like an estimate in advance for procedures or tests performed at SoutheastHEALTH, please call 573-519-4944. 

You may also complete and submit our secure online Patient Cost Estimate Request Form below.  The information provided is only an estimate for services and not a guarantee of charges for these services. 

For questions related to insurance allowances, deductibles, out of pocket expenses, or any other questions please contact the customer service number on the back of your insurance card.

Charge estimates will be completed as quickly as possible – please allow 3-5 business days for our response.

Patient Information
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Patient Gender
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Medical Information Regarding Cost Estimate Request
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The procedure or service is:
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Do you have insurance?
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Preferred Methods of Contact
Contact me with QUESTIONS by:
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Do we have permission to leave a voicemail?
Send my estimate by:
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