Estimate Your Cost of Care

We can help you understand your health care expenses by providing an estimate of charges and out-of-pocket costs for most hospital services here at Valley Medical Center.

Charges for medical care can be confusing and complex. Services for each patient are not one-size-fits-all in most cases and must be customized to a patient’s specific needs. Prior to hospitalization, it’s very difficult to know all of the additional needs that could arise, but we are committed to giving you as much information as possible to help you understand what to expect when your bill arrives and help you make informed decisions regarding the cost of the care you receive. We offer two levels of information: 

1. Links to our latest standard hospital charges:

Please note, the prices listed are not personalized to you in any way and do not imply that’s what your insurance plan reimburses. In addition, it is not all-inclusive of services you may receive for your particular stay based on your specific needs. It is most helpful for the purposes of comparison of standard charges between hospitals.

 

2. To request a more comprehensive, customized cost estimate based on your insurance plan or self-pay, please fill out the form below and one of our Financial Advocates will follow up with you.

 Patient Rep

How to Request a Cost Estimate

  1. Once you have seen your provider, ask your provider's office for the specific procedure code(s) of the medical procedure he/she recommends.
  2. Complete and submit the cost estimate form below.
  3. One of our Financial Advocates will review your request and call you within three business days to provide information about your estimate. 

Questions?

If you have questions or need additional help, our Financial Advocates are available to assist you. Please call us at 425-656-5599 or visit us at the hospital in person, Monday through Friday between 8:30 AM and 5 PM.

Request an estimate

Please fill out this form


PATIENT INFORMATION

* First Name:

Middle Name:

(enter NMI if no middle initial)

* Last Name:

Email:

* Date of Birth:
 [None] Select a Date Delete the Date
(click first calendar icon to select, second calendar icon to remove)

* Phone:
  

ext.  

 


INSURANCE INFORMATION
*Insurance Carrier:

Specify Insurance Carrier:

* Group ID Number:

* Insurance ID Number:

AETNA Card Premera ID Card Regence ID Card

 


SUBSCRIBER INFORMATION

* First Name:

* Last Name:

* Date of Birth:
 [None] Select a Date Delete the Date
(click first calendar icon to select, second calendar icon to remove)

 


REASON FOR VISIT

* Procedure Code—Description:

(ask your provider for this code. Example: "27130 – Total Hip Replacement")

Comments:
 

 


CONTACT PREFERENCE

* Best Time to Reach You:

(we'll contact you within 3 business days)

 


ACKNOWLEDGEMENT
* Disclaimer:
  Please check here to acknowledge your acceptance
By checking this box, I acknowledge that I am requesting a cost estimate for a procedure(s) at Valley Medical Center. I understand that the estimate will be based on the information I have provided and the most current benefits available from the insurance company. Additional charges will apply if other services are provided that are unknown at the time of this estimate. This estimate may not include all charges for incidental supplies related to the services performed. In addition, this estimate does not include any durable medical equipment, physician, surgeon, anesthesiologist, pathologist, or radiologist charges. Those fees are billed separately by their respective billing agents, and are not included in this estimate.

* How did you hear about this service?:

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