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Billing & Insurance

General Content

Request a Cost Estimate

Understanding the pricing of your healthcare services can be confusing. At Rochester Regional Health, our Patient Estimates Team will be pleased to assist you with requesting a price estimate for your planned hospital or physician services.

Please fill out the form below and we will get back to you within 3 business days. The more accurate and detailed information you provide, the faster your request will be completed. If you need a quicker response, please call (585) 922-2678 or email [email protected]

Name*
Birthday
Date of birth (DOB)
Area code and number
Preferred
Best way to contact you

Procedure Information

Note: Current Procedural Terminology (CPT) is a medical code set that is used to report medical services to physicians and health insurance companies.

Please contact the referring office for a Current Procedural Terminology (CPT) code.
Rochester Regional Health location for procedure
Do you have insurance?*

If no, the estimate will be calculated on a self-pay basis.

Insurance Information

Have you verified your benefits with your insurance provider?*

If no, please note that the estimate will be completed with the benefit information noted on the insurance provider website and we will recommend contacting your insurance for further details.

Insurance Benefit

$
amount you pay before insurance coverage starts to pay
$
amount left before reaching maximum required to pay
Do you have any financial assistance?

Disclaimer

All requests may take up to 3 business days. The more accurate the information provided above, the faster the request will be completed. Please note that all professional billing (i.e. billing for surgeons, radiologists, physicians, and anesthesiologists) will be done separately and are not included in the estimates unless stated otherwise.


This estimate is based on our current pricing and is subject to change.  While we make every effort to ensure the accuracy of our estimates, it is impossible to predict final out of pocket costs due to the many variables within the actual services that are not determined until the day of care.  Therefore, please note the estimate provided is not a guarantee of cost for this service.  Additional costs may be involved if the physician chooses to do a different set of testing, additional procedures, or requests consults from other providers on the case.

Confirm*
Message to the Patient Estimates Team memeger preparing your estimate
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